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HYPERBARIC MEDICINE

Oxygen will always be synonymous of life, health, beauty and youth.

HYPERBARIC MEDICINE

Hyperbaric Medicine is the branch of science that studies the physiological and physiopathological changes of living beings subjected to pressures higher than atmospheric in their adaptation to the environment and together with the therapies of their associated pathologies.

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Hyperbaric oxygenation is based on diving medicine. In fact, its beginnings date back to the 1930s when oxygen breathing began to be used in the decompression of divers to shorten them.

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Although hyperbaric medicine has been used since the 17th century, it was only in 1960 in Amsterdam that the first Congress of hyperbaric oxygen therapy applied to pathologies other than diving was held, where it was mainly applied to infections produced by "anaerobic" germs; after that it was applied to other pathologies and different scientific societies were formed in the world such as the United States of America, Europe, Russia and Japan.

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PHYSICAL FOUNDATIONS OF HYPERBARIC MEDICINE

The main foundation is the use of pure oxygen at pressures above 1.6 ATA.


Hyperbaric oxygen therapy can be defined as a therapeutic method in which pure oxygen is breathed at partial pressures above atmospheric pressure. This oxygen finishes saturating the hemoglobin of the arterial and venous blood and dissolves in the plasma, following the mechanics of Henry's law with therapeutic effects.

It is the use of oxygen as a drug whose dose is given by the partial pressure of oxygen and the time elapsed at that pressure and where the application system is the hyperbaric chamber.


The patient is comfortably seated or eventually lying inside the chamber where through an oronasal mask or a helmet type cephalic device breathes pure oxygen.


The increased pressure can only be felt in the ears. By means of simple instructions, the patient learns how to compensate for the pressure without difficulty. They are always accompanied throughout the treatment inside the chamber by trained personnel.

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Indications

EMERGENCY

 

  • Carbon Monoxide Poisoning.

  • Gas gangrene (Clostridial myonecrosis).

  • Gas Embolism.

  • Decompression Illness. (DCI)

 

 

 

 

 

 

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URGENCY

  • Necrotizing Infections of Soft Tissues.

  • Anaerobic Cellulite Crackling.

  • Necrotizing Fasciitis.

  • Fournier's disease.

  • Non-Clostridium Myonecrosis.

  • Progressive Bacterial Gangrene.

  • Compartment Syndrome (Crush Injury).

  • Acute Traumatic Ischemia.

  • Member Trauma.

  • Thermal Burns.

  • Flaps and grafts with vascular compromise.


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SCHEDULED

 

  • Scarring Disorders

  • Refractory Chronic Hypoxic Wounds

  • Cubitus sores

  • Venous Ulcers

  • Arterial Ulcers

  • Diabetic Foot

  • Refractory Osteomyelitis

  • Aseptic Necrosis of the Head of Femur

  • Radionecrosis and Osteoradionecrosis

  • Actinomycosis

 

 

SPECIAL CASES

 

  • Sudden Deafness

  • Diffuse Peritonitis in Pediatrics

  • Multiple Sclerosis

  • Exceptional Acute Anemia

  • Sports Medicine

APLICATIONS

HBO (hyperbaric oxygenation) is applied for:

 

  • Recovery of suffering tissues;

  • Refractory lesions, frequent relapses.

  • Injuries requiring surgical debridement or amputation;

  • Clinical conditions in which it is the only treatment;

  • Serious and/or complex injuries;

  • Failure to respond to conventional treatments;

  • Rapid worsening with risk of death;

  • Soft tissue injuries: face, hands, feet, perineum, genitals, breasts;

 

 

General Surgery and Gastroenterology:

 

  • Ischemia caused by surgical intervention.

  • Infection of the surgical site.

  • Dehiscencies due to surgery.

  • Non-surgical purulent peritonitis.

  • Refractory paralytic ileus.

  • Acute pancreatitis.

  • Ulcerative colitis in activity.

  • Fistulized Crohn's disease.

  • Enterocutaneous fistulas.

  • Complications of anorectal surgery.

  • Post-transplantation hepatic ischemia.

  • Multiple abscesses of parenchymal organs.

  • Intestinal pneumatosis.

  • Adenovirus hemorrhagic cystitis.

 

 

Trauma:

 

  • Ischemic trauma of extremities (crushing, deglobing, exposed fractures, loss of substances, ruptures of vessels).

  • Trauma in previously compromised areas (necrotic, ischemic, irradiated areas, etc.).

  • Trauma to soft tissues: face, neck, breasts, perineum, genitals, hands and feet.

  • Trauma with secondary infection.

  • Advancement of initial traumatic injuries.

  • Skin burn injuries.

  • Accidents caused by biological agents (animal bites, etc.)

  • Pneumoencephalon.

 

 

Infections:

 

  • Bacterial infections of soft parts: aerobic and anaerobic, purulent and/or necrotizing (e.g. pyoderma gangrenosa, pyomyositis, etc.).

  • Erysipelas.

  • Invasive mycosis (Actinomycosis, Mucormycosis, etc).

  • Primary osteomyelitis with poor response to treatment.

  • Leprosy in selected cases.

  • Otitis medias, external and mastoiditis of chronic evolution, malignant external otitis.

  • Epidermolysis bullosa

  • Bacterial infections followed by viral diseases (chickenpox, herpes zoster).

 

 

Wounds:

 

  • Refractory infections / multi-resistant germs.

  • Soft tissues: face, neck, perineum, genitals, hands and feet.

  • Failed graft or previous flap.

  • Clear background (ischemic).

  • Associated osteomyelitis.

  • Possibility of amputation.

  • Presence of fistula.

  • Absence of signs of scarring.

  • Irregular background

  • Wounds in previously compromised areas (necrotic, fibrotic, ischemic, irradiated areas, etc).

  • Extensive and/or deep wounds.

 

 

Vascular diseases:

 

  • Ischemic wounds from peripheral obstructive arterial disease.

  • Inflammatory arteriopatias.

  • Diabetic foot.

  • Venous ulcers.

  • Skin lesions

 

Orthopedics and Traumatology:

 

  • Exposed fractures in selected cases.

  • Post-surgical osteomyelitis, post fractures and hematogenic.

  • Septic arthritis.

  • Pseudoarthrosis with or without infection.

  • Infected orthopedic surgery.

  • Aseptic necrosis of the femoral head.

 

 

Aesthetic and Plastic Surgery:

 

  • Thermal, electrical and chemical burns.

  • Injuries that are difficult to heal.

  • Grafts and flaps compromised or at risk.

  • Cellulite, fasciitis and myositis, after reconstructive and aesthetic plastic surgeries (breasts, abdomen, and liposuction).

  • Necrotizing soft tissue infections after invasive cosmetic procedures (such as injection or application of autologous biologics, synthetic and semi-synthetic fillers).

  • Dehiscencies of surgeries compromising the aesthetic result.

  • Patients at high risk of complications (diabetics, smokers, etc.) with the aim of prioritizing post-traumatic tissue ischemia.

  • Decrease in post-operative edema in selected cases.

 

Observations: It is not indicated for the previous application of HBO in healthy patients who will undergo aesthetic plastic surgery.

 

 

Actinic injuries:

 

Due to its unique action on post-irradiated human tissues (mainly due to the neo-angiogenic effect), HBO is the only treatment capable of significantly and durably recovering tissues, and is indicated in the following cases:

 

  • Actinic dermatitis.

  • Actinic myocytis.

  • Actinic colo-proctitis.

  • Actinic cystitis.

  • Peripheral actinic neuropathy

  • Actinic myelitis and encephalitis in particular cases.

  • Implants in tissues compromised by radiotherapy.

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