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  • HYPERBARIC OXYGEN THERAPY

    Hyperbaric oxygen therapy is the systematic delivery of oxygen at values two to three times greater than atmospheric pressure. Patients are placed in a chamber and breathe 100 percent oxygen while exposed to elevated ambient pressures.

    Barometric Oxygen Chamber

    Patient Referral – Consultation Procedures

    Hyperbaric oxygen therapy can be offered as a consultation service. Patients are evaluated through referral by their attending physician. Treatment regimens and other recommendations are communicated to the referring/primary care physician who remains responsible for the patient’s general medical management. Successful therapy requires a multidisciplinary approach to care.

    Treatment Protocols

    Oxygen delivered under increased atmospheric pressure becomes a potent drug. Hyperbaric oxygen must be administered carefully to avoid toxic effects.

    The patient’s clinical response often dictates the number of treatments that may be required. Non-healing wounds such as chronic refractory osteomyelitis, osteoradionecrosis or soft tissue radiation may require 20–40 treatments, while compromised surgical flaps/split thickness skin graft may require only ten.

    Hyperbaric therapy treatments generally last about two hours. Treatments are administered once or twice a day on an inpatient or outpatient basis. During hyperbaric therapy, patients may watch television, listen to the radio or converse with visitors and staff. Relaxation techniques can be utilized to help ease confinement anxiety.

    Physiological Basis of Therapy

    Hyperbaric oxygen therapy utilizes a variety of action mechanisms. Some action mechanisms are related directly to elevated pressures; others are related to increased oxygen effects in the blood stream, tissues and cells.

    Chamber pressure above sea level results in:

    • a 200% surface equivalent of oxygen delivered to the patient through normal respiration. This significant increase in oxygen tension can allow a ten-fold increase to chronic wound tissues.

    The effects of increased oxygen tensions are seen in a variety of different situations:

    • the reduction of edema in the wound areas
    • stimulates the body’s own natural resources to grow new micro blood vessels (angiogensis)
    • increase in oxygen diffusion in the hypoperfused wound; the resulting stimulation enhances healing in skin grafts, selected problem wounds and compromised flaps
    • stimulation of the body’s immune response by leukocytic activity, providing an excellent adjucant to IV antibiotic and local wound care
    • the inhibition of alpha toxin production by the clostridial organisms in gas gangrene

    Hyperbaric Medical Staff

    Our two monoplace hyperbaric chambers are staffed by hyperbaric-certified nurses and a board-certified hyperbaric physician. Therapeutic services are provided for electively referred outpatients and medically complex inpatients requiring long-term acute care.

    • hyperbaric oxygen (HBO) therapy
    • coordination of interdisciplinary services including surgery, respiratory therapy, physical and occupational therapy, dietary and wound care management
    • transcutaneous oxygen monitoring

    Treatment Indications and Insurance Coverage

    These cases are approved by CMS and are recognized by Medicare and most other third party payers. Preauthorization is obtained prior to initiation of treatment.

    Adjunctive Therapy

    • enhancement of healing in selected problem wounds
    • compromised surgical skin grafts and flaps
    • chronic refractory osteomyelitis
    • radiation injury: osteoradionecrosis and soft tissue radiation necrosis
    • necrotizing soft tissue infections
    • gas gangrene (clostridial myonecrosis)
    • certain cases of exceptional blood loss anemia

    Value as Adjunctive Therapy

    As an adjunctive to the other recommended treatment modalities, hyperbaric oxygen therapy has been shown to optimize results in particular cases. The level of success depends on such factors as impairment of tissue perfusions, associated systemic disorders and level of tissue damage before the onset of hyperbaric therapy. For best results, suspected hypoxic wound complications should be addressed early. In particular, potential skin grafts, flap failures, crush injuries or gas gangrene should be treated as soon as possible at the onset of pathology.

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