Uses of Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy is most often used in the following conditions:
- Radiation tissue damage, including damage to bone and small blood vessels as a result of therapeutic radiation, radiation cystitis or radiation proctitis
- Preparation for tooth extraction or surgery in areas previously treated with radiation
- Decompression sickness from diving accidents
- Air or gas embolism (from diving, indwelling catheters or surgery complications)
- Enhancement of healing in compromised (hypoxic or ischemic) wounds
- Osteomyelitis (refractory)
- Clostridial myonecrosis (gas gangrene)
- Necrotizing soft tissue infections
- Compromised skin grafts and muscle flaps following surgery
- Crush injury, compartment syndrome or acute traumatic ischemia
- Severe carbon monoxide poisoning
- Intracranial abscess
- Exceptional blood loss (anemia)
Wound Evaluation
Predicting Response
Wound healing can be compromised by many factors, including diseases such as diabetes or chronic lung disease and systemic issues such as poor nutrition or severe anemia. A number of localized conditions can also compromise wound healing, including infection and poor arterial blood flow. Poor blood flow may result in tissue hypoxia due to poor oxygenation. A minimum tissue oxygenation level (PO2) is necessary for fibroblast proliferation and collagen production normally required for wound healing.
An ideal candidate for hyperbaric oxygen therapy presents with a wound that is hypoxic under normal respiration, but demonstrates oxygenation under oxygen challenge. To test these conditions, we use transcutaneous oximetry, a method in which small sensors are placed on the skin around the wound. Oxygen levels are measured under normal conditions, then under oxygen challenge, either via a facemask or in the hyperbaric chamber. If there is no response to an oxygen challenge, it is unlikely that hyperbaric oxygen therapy will be of benefit.
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