Re: Burns; healthlink.mcw.edu and drhuhc.org
The Healing Powers of Hyperbaric Oxygen Treatment
Oxygen is essential to proper healing of bodily tissues, whether it's skin, muscle or bone. In most cases, the act of breathing combined with a healthy network of veins and arteries provide enough oxygen for body tissues to heal. However, in certain circumstances, hyperbaric oxygen treatment is used to substantially increase oxygen flow within tissues to improve healing.
Patients undergoing hyperbaric treatment are placed in a chamber where 100% oxygen is circulated. The oxygen is pressurized so that air pressure may be 2-3 times greater than normal. This allows the lungs and skin to absorb more concentrated oxygen in a shorter period of time.
Hyperbaric oxygen treatment was originally used to relieve scuba and deep-sea divers of a dangerous condition called decompression sickness or "the bends." While ascending from underwater, nitrogen gas bubbles may form in the lungs, tissues and bloodstream. Blood flow may be blocked, with disastrous results, and blood vessels may be damaged. Hyperbaric treatment neutralizes the effects of nitrogen.
Today, the Undersea and Hyperbaric Medical Society has approved use of hyperbaric oxygen for several other conditions besides the bends. The length and number of treatments depends on the condition and its severity.
Air or Gas Embolism: This is similar to the bends, when air or gas bubbles enter arteries or veins, reducing blood flow and affecting oxygen circulation.
Carbon Monoxide Poisoning: Carbon monoxide (CO), a colorless, odorless gas, is a byproduct of combustion. It binds to red blood cells, blocking delivery of oxygen to the body. Hyperbaric oxygen accelerates the clearance of CO from the body, restoring oxygen delivery and preventing toxic effects on the central nervous system and blood vessels.
Gas Gangrene: This bacterial infection eats away soft tissues, releases toxins into the blood stream and inhibits the body's defense mechanisms. These bacteria prefer low-oxygen concentrations. High doses of oxygen via hyperbaric therapy inhibit bacteria and toxin production.
Crush Injuries: Complications of crush injuries, such as from motor vehicle accidents, falls and gun shots, are very frequent. By increasing oxygen delivery to injured tissues, hyperbaric treatments reduce swelling, improve healing and help fight infection.
Problem Wounds: Wounds may fail to respond to standard care because of low oxygen levels and impaired circulation. Foot ulcers in diabetics are one such problem. By increasing oxygen levels within the wound tissues, hyperbaric therapy promotes healing.
Anemia/Blood Loss: In cases where a patient can't accept a blood transfusion for medical or religious reasons, sufficient oxygen delivery (via red blood cells) might be compromised. Hyperbaric treatment increases the oxygen content of existing red blood cells.
Intracranial Abscess: A sinus infection or bone infection of the skull may form an abscess within the skull or brain. Antibiotics may be ineffective and white blood cells require a minimum oxygen level to kill bacteria. Hyperbaric treatment provides oxygen for white blood cells and inhibits bacteria that need low oxygen levels to grow.
Soft Tissue Infections: These are serious infections -- in which tissue is dying -- that may be complicated by conditions such as diabetes or vascular disease. While primary treatments are removing the infected tissue and administering antibiotics, hyperbaric oxygen may inhibit bacteria from growing and enhance the ability of white blood cells to kill bacteria.
Bone Infections: Osteomyelitis, infection of the bone, that does not respond to standard treatment may benefit from hyperbaric oxygen. It inhibits bacterial growth, increases the killing power of white blood cells and enhances the effects of some antibiotics.
Radiation Therapy Complications: Chronic complications of radiation therapy used to treat cancer may result from scarring and narrowing of the blood vessels. Hyperbaric treatment allows more oxygen to reach these damaged areas and helps prevent tissue from dying for lack of blood and oxygen flow. It is most often used in the head and neck areas.
Skin Grafts: The success of transferred skin grafts or flaps (which might include skin, deeper tissue, muscle and bone) is largely dependent on sufficient oxygen supply to the affected area. Hyperbaric treatment can be used to saturate the area with oxygen before and after grafting.
Burns: Hyperbaric therapy is sometimes used to treat burns to the hands, face or groin area, or for deep second-degree and third-degree burns that cover more than 20% of the patient's body. Hyperbaric oxygen reduces swelling, limits progression of the burn injury (which continues 3-4 days after the initial injury) and may diminish lung damage from inhalation of heat and smoke.
At the Medical College of Wisconsin, researchers are studying hyperbaric therapy for additional uses, alone and in combination with other treatments. Medical College researchers have pioneered the use of hyperbaric oxygen in conjunction with NASA's near-infrared light-emitting diode technology for treatment of hard-to-heal wounds.
Harry T. Whelan, MD
Professor of Neurology, Pediatrics, Hyperbaric Medicine
Medical College of Wisconsin
Medical Director
Froedtert & Medical College Hyperbaric Medicine
Pediatric Neurologist
Children's Hospital of Wisconsin |
