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Hyperbaric oxygen and wound healing


Wound healing is a topic of great interest and involvement for surgeons. Although much of the physiology of wound healing is understood, there are still gaps in our understanding of the phenomenon. The surgeon attempts to modify the wound environment through various means at his disposal, one such method is hyperbaric oxygen treatment.



I. Understanding the history of hyperbaric oxygen therapy treatment

Hyperbaric oxygen therapy treatment is the use of 100% oxygen at a pressure higher than atmospheric pressure. The patient breathes 100% oxygen intermittently while the pressure in the treatment chamber is increased to greater than 1 absolute atmosphere (ATA). hyperbaric oxygen therapy treatment had an exciting and interesting beginning. in 1620, Drebbel developed a single-atmosphere diving bell. Thereafter, an English clergyman named Henshaw built and administered the first famous chamber called the domicilium for the treatment of a variety of diseases. in 1879, the French surgeon Fontaine continued the idea of treating patients under increased pressure when he built a pressurized mobile operating room. Dr. Orville Cunningham, professor of anesthesiology, operated the so-called "Steel Ball Hospital". Built in 1928, the structure was six stories high, 64 feet in diameter, and could reach a pressure of three atmospheres. The hospital closed in 1930 because of a lack of scientific evidence that the treatment could alleviate disease, and was dismantled for scrap during World War II. The modern era of hyperbaric medicine began in 1937 when Behnke and Shaw used hyperbaric chambers to treat decompression sickness (DCS), but it was not until 1955 that hyperbaric oxygen therapy treatment was used for diseases other than DCS. That year, Churchill-Davidson began using oxygen therapy in hyperbaric chambers to treat radiation-induced injuries in cancer patients, and in 1956, Boerema in the Netherlands even performed the first reported cardiac surgery in a hyperbaric chamber.



Since then, the number of indications for the use of hyperbaric oxygen therapy treatment has been steadily increasing, so much so that one article mentions 132 documented past and present indications for its use. The Undersea and Hyperbaric Medical Society (UHMS) has recognized various indications as "approved" indications that have also been approved by the British Hyperbaric Society. 2004 European Consensus Conference also recommended hyperbaric oxygen therapy for a number of additional conditions based on sufficient evidence in the form of expert consensus opinion.


Exploring other benefits of hyperbaric oxygen treatment

In addition to the approved indications, several areas are being explored to determine whether hyperbaric oxygen treatment may have some clinical benefit. These areas include aging, stroke, multiple sclerosis, sports injuries, altitude sickness, myocardial infarction, brain injury, migraine, glaucoma, head injury, management of chronic fatigue in HIV-positive patients, and improved survival of free flaps.



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