Other HBO Conditions Treated

Most people realize that hyperbaric oxygen therapy is utilized to treat decompression sickness or the bends. However, few can recognize the other medical conditions for which hyperbaric therapy is indicated.

Breast Chest Wall Radionecrosis

Therapeutic Radiation Injury Radiation therapy for cancer can result in radiation necrosis and wounding of the primary organ or surrounding organs. Hyperbaric therapy is the only medical modality known to reverse this injury type.

Diabetic Foot Wounds Hyperbaric oxygen therapy is indicated for refractory diabetic foot wounding of Wagner classification 3 or higher. Hyperbaric reduces the potential complication of major amputation by 95%.

Wagner Grade 3 Wound

Photo by Doug Shick, used under Creative Commons Attribution 2.0 Generic license

Carbon Monoxide Poisoning Hyperbaric therapy is indicated in CO patients with: CO levels > 25%, transient unconsciousness, neurologic or cardiac dysfunction, acidosis and pregnant women with CO level > 10%. HBO confers a 46% reduction in neurocognative change.

Compromised Surgical Flaps/Grafts HBO can save the threatened surgical flap or graft. The dehisced surgical wound can have vascularity only 20% of baseline. Hyperbarics is utilized for threatened split-thickness skin grafts, incomplete take of skin grafts, and threatened myocutaneous rotational flaps.

Myocutaneous Flap to the Shoulder

Photo by James Emery, used under Creative Commons Attribution 2.0 Generic license

Trauma HBO is utilized in crush injuries, compartment syndromes and acute peripheral ischemia. HBO saves and maintains tissue and reverses the small vessel ischemia not amenable to medical or surgical management.

Chronic Refractory Osteomyelitis Osteomyelitis is a purulent inflammation of bone most often caused by bacteria and other microorganisms. Chronic refractory osteomyelitis is markedly helped by HBO. HBO enhances WBC bacterial killing function and promotes formation of the collagen matrix within the medullary bone.

Gas Bubbles in the Cerebral Arteries

Air Gas Embolism / Arterial Gas Embolism Arterial gas embolism is associated with diving injuries, however the prominent cause is medical procedures. AGE is a complication of lung biopsies, orthopaedic and laparoscopic procedures and cardiac bypass surgery. The clinical presentation is that of a stroke, with or without seizure.

Thermal Burns HBO for thermal burns reduces the level of injury and reduces the number of grafts needed for reconstruction. It is extremely important for facial and extremity burns, especially when grafting can be problematic.

Photo by Image*After, used under Public Domain license

Exceptional Blood Loss Anemia HBO is utilized for exceptional blood loss anemia is which transfusion is not possible. HBO is administered in conjunction with erythropoietin analogs, IV iron medications and pressors agents.

Gas Gangrene

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Gas Gangrene is caused by various clostridium species of bacteria. It is associated with rapid tissue destruction secondary to toxin formation. Alpha toxin production is halted by tissue oxygen levels > 300mm Hg. Gas gangrene is an antibiotic, HBO, surgical disease. HBO minimizes heroic surgery with massive tissue loss. Mortality reduction is 13% HBO/Surgery vs. 38% surgery alone.

Necrotizing Fasciitis

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Necrotizing fasciitis is divided into Type I, a polymicrobial infection caused by aerobe and anaerobic bacteria that affects patients with diabetes or other causes of immune suppression; and Type 2: which occurs in patients without comorbid conditions. Type 2 necrotizing infection is usually due to group A beta hemolytic Streptococcus. Predisposing factors to Type 2 include surgical procedures, decubitus ulcers, childbirth and parenteral drug use. Hyperbaric as adjunctive therapy to antibiotics and surgery significantly reduces morbidity, mortality, and associated amputations in necrotizing soft tissue infection. Mortality without HBO is 34%, while mortaility with HBO is 11.9%.

Other Medical Conditions Treated by the Hyperbaric Medicine Department:

• Therapeutic Radiation Wounding
• Diabetic Foot Wounds
• Chronic Refractory Osteomyelitis
• Compromised Surgical Flaps or Grafts
• Selected Problem Wounds
• Carbon Monoxide Poisoning
• Thermal Burns
• Necrotizing Tissue Infections
• Trauma, Crush Injury and Acute Peripheral Ischemia
• Air Gas Embolism or Arterial Gas Embolism