Hyperbaric Oxygen Therapy References

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Hi,

I did a quick search on Medline, and there's a lot of stuff on

hyperbaric oxygen therapy there. I had some trouble getting all hits

to show though, so I might not have seen many useful references.

Maybe useful???

Aase Marit

The role and effectiveness of adjunctive hyperbaric oxygen therapy in

the management of musculoskeletal disorders.

Wang J, Li F, Calhoun JH, Mader JT.

Department of Orthopaedics and Rehabilitation, University of Texas

Medical Branch, Galveston, TX 77555-1115, USA. juewang@...

The management of musculoskeletal disorders is an increasing

challenge to clinicians. Successful treatment relies on a wide range

of multidisciplinary interventions. Adjunctive hyperbaric oxygen

(HBO) therapy has been used as an orthopaedic treatment for several

decades. Positive outcomes have been reported by many authors for

orthopaedic infections, wound healing, delayed union and non-union of

fractures, acute traumatic ischemia of the extremities, compromised

grafts, and burn injuries. Severe side effects have also been

reported with this therapy. To aid in the use of HBO therapy in

orthopaedics, we reviewed 43 papers published in the past four

decades and summarised the mechanisms, effectiveness, indications and

contraindications, side effects, and cost impact of adjunctive

hyperbaric oxygen therapy in the management of difficult

musculoskeletal disorders. Adjunctive HBO therapy is an effective

treatment modality for the management of some severe and refractory

musculoskeletal problems. If appropriate candidates are carefully

identified, hyperbaric oxygen is a limb- and sometimes life-saving

therapy. HBO therapy significantly reduces the length of the

patient's hospital stay, amputation rate, and wound care expenses.

Thus, it is a cost-effective modality. A clinician must understand

the side effects and risks of HBO treatment. Close monitoring

throughout the treatment is warranted to minimise the risk to the

patients.

Publication Types:

* Review

* Review, Tutorial

PMID: 12432205 [PubMed - indexed for MEDLINE]

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Orthop Nurs. 1992 Nov-Dec;11(6):9-15. Related Articles, Links

Fundamentals of hyperbaric oxygen therapy.

Schaefer SE.

Hyperbaric oxygen therapy (HBO) is an adjunctive treatment used for

wound healing. HBO treatments are given by increasing the atmospheric

pressure in a chamber while the patient is breathing 100% oxygen.

Many orthopaedic disease entities can benefit from HBO therapy. For

the orthopaedic nurse to recognize potential HBO patients, a basic

understanding of HBO therapy is necessary. Knowledge of diseases that

can be treated with HBO, the side effects of HBO, and educating a

patient for HBO therapy are all important aspects of hyperbaric

therapy.

PMID: 1491885 [PubMed - indexed for MEDLINE]

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2: Orthopedics. 2002 Mar;25(3):303-10. Related Articles, Links

Hyperbaric oxygen.

Strauss MB, B.

Department of Hyperbaric Medicine, Long Beach Memorial Medical

Center, PACT Clinic, Veterans Administration Medical Center, CA, USA.

This cutting edge article discusses the most frequent uses of

hyperbaric oxygen for the orthopedic surgeon. Hyperbaric oxygen

therapy is an adjunct to orthopedic interventions when healing

problems are anticipated due to wound hypoxia or uncontrolled

infection.

Publication Types:

* Review

* Review, Tutorial

PMID: 11918035 [PubMed - indexed for MEDLINE]

Arch Orthop Trauma Surg. 2002 Mar;122(2):115-9. Epub 2001 Sep 06.

Related Articles, Links

Hyperbaric oxygenation as a successful therapeutic approach in oral

wound dehiscence after operative stabilization of an unstable

post-traumatic odontoid non-union.

Braune C, Hamm J, Bohmer D, Scale D, Zichner L.

Department of Orthopaedic and Trauma Surgery, Orthopadische

Universitatsklinik und Poliklinik Friedrichsheim, Marienburgstrasse

2, 60528 furt am Main, Germany. C.Braune@...

The non-operative treatment of unstable traumatic 's type II

odontoid fractures has a high risk potential to develop non-unions.

Even after operative stabilization literature reveals non-union rates

up to 20%. Acute life threatening complications are tetraplegia and

apnoea. Long-term complications induce chronic myelopathy resulting

from persistent myeloradicular compression. We report the case of a

patient with a 17-year-old post-traumatic pseudarthrosis of the dens

axis following conservative treatment of an unstable type II

fracture. By that time, the female patient, then 37 years old, was

admitted to our hospital with early signs of cervical tetraplegia.

After initial reposition and short-term immobilization with a

halothoracic vest we performed a ventrodorsal atlantoaxial

spondylodesis. Failure of anterior cervical plate stabilization and

autologous graft resorption without a solid segmental fusion

instigated a secondary surgical intervention. Postoperative

therapy-resistant oral wound dehiscence showed an exposed autograft

and osteosynthetic material. The reported positive effect of

hyperbaric oxygenation on wound healing in problem cases led us to

attempt this means of therapy. With a daily exposure to hyperbaric

oxygenation, the dehiscence closed within 25 days. As a result of our

experience in this case, hyperbaric oxygenation should be considered

as a therapeutic option in postoperative complication management in

orthopaedic surgery.

Publication Types:

* Case Reports

PMID: 11880916 [PubMed - indexed for MEDLINE]

Effect of hyperbaric oxygen treatment on incorporation of an

autogenous cancellous bone graft in a nonunion diaphyseal ulnar

defect in cats.

Kerwin SC, DD, Elkins AD, Oliver JL, Hosgood G, Pechman RD Jr,

Dial SL, Strain GM.

Department of Veterinary Clinical Science, School of Veterinary

Medicine, Louisiana State University, Baton Rouge 70803, USA.

OBJECTIVE: To determine whether hyperbaric oxygen treatment (HBOT)

would affect incorporation of an autogenous cancellous bone graft in

diaphyseal ulnar defects in cats. ANIMALS: 12 mature cats. PROCEDURE:

Bilateral nonunion diaphyseal ulnar defects were created in each cat.

An autogenous cancellous bone graft was implanted in 1 ulnar defect

in each cat, with the contralateral ulnar defect serving as a

nongrafted specimen. Six cats were treated by use of hyperbaric

oxygen at 2 atmospheres absolute for 90 minutes once daily for 14

days, and 6 cats were not treated (control group). Bone labeling was

performed, using fluorochrome markers. Cats were euthanatized 5 weeks

after implanting, and barium sulfate was infused to evaluate

vascularization of grafts. Ulnas were evaluated by use of

radiography, microangiography, histologic examination, and

histomorphometric examination. RESULTS: Radiographic scores did not

differ between treatment groups. Microangiographic appearance of

grafted defects was similar between groups, with all having adequate

vascularization. Differences were not observed between treated and

nontreated groups in the overall histologic appearance of decalcified

samples of tissue in grafted defects. Mean distance between

fluorescent labels was significantly greater in cats given HBOT than

in nontreated cats. Median percentage of bone formation in grafted

defects was significantly greater in cats given HBOT. CONCLUSIONS:

Hyperbaric oxygen treatment increased the distance between

fluorescent labels and percentage of bone formation when

incorporating autogenous cancellous bone grafts in induced nonunion

diaphyseal ulnar defects in cats, but HBOT did not affect

revascularization, radiographic appearance, or qualitative histologic

appearance of the grafts.

PMID: 10850847 [PubMed - indexed for MEDLINE]

Hyperbaric oxygen therapy mitigates the adverse effect of cigarette

smoking on the bone healing of tibial lengthening: an experimental

study on rabbits.

Ueng SW, Lee SS, Lin SS, Wang CR, Liu SJ, Tai CL, Shih CH.

Department of Orthopaedic Surgery and Hyperbaric Oxygen Therapy

Center, Chang Gung Memorial Hospital, Taiwan, Republic of China.

OBJECT: We investigated whether -intermittent hyperbaric oxygen (HBO)

therapy can mitigate the adverse effects of cigarette smoking on the

bone healing of tibial lengthening by using a previously validated

rabbit model. METHODS: Eighteen male rabbits were randomly divided

into three groups of six animals each. Group 1 (smoking plus HBO)

went through intermittent cigarette smoke inhalation and hyperbaric

oxygen therapy, group 2 (control) did not go through intermittent

cigarette smoke inhalation or hyperbaric oxygen therapy and group 3

(smoking) went through intermittent cigarette smoke inhalation. Each

animal's right tibia was lengthened 5 mm by using an uniplanar

lengthening device. Bone mineral density (BMD) study was performed

for all the animals at 1 day before operation and 3, 4, 5, and 6

weeks after operation. All of the animals were killed at 6 weeks

postoperatively for biomechanical testing. RESULTS: By using the

preoperative BMD as an internal control, we found that the BMD of

group 1 (smoking plus HBO)and group 2 (control) was superior to that

of group 3 (smoking). The mean %BMD at 3, 4, 5, and 6 weeks were

58.6%, 66.6%, 73.7%, and 83.8%, respectively, in group 1, whereas the

mean %BMD were 52.0%, 64.3%, 70.1%, and 76.2%, respectively, in group

2, and the mean %BMD were 46.2%, 54.0%, 64.9%, and 69.4%,

respectively, in group 3 (two-tailed t test, p > 0.05, p > 0.05, p >

0.05, and p < 0.05 at 3, 4, 5, and 6 week respectively between group

1 and group 2, p < 0.01,p < 0.01,p < 0.01, and p < 0.01 at 3, 4, 5,

and 6 week, respectively, between group 1 and group 3 and p < 0.05, p

< 0.05, p < 0.05, and p < 0.05 at 3, 4, 5, and 6 week respectively

between group 2 and group 3). By using the contralateral nonoperated

tibia as an internal control, we found that the torsional strength of

group 1 (smoking plus HBO) and group 2 (control) was superior to that

of group 3 (smoking). The mean percentage of maximum torque was 80.9%

in group 1 (smoking plus HBO) and was 78.0% in group 2 (control),

whereas the mean percentage of maximum torque was 59.6 % in group 3

(smoking) (two-tailed t test, p < 0.05 between groups land 3 and

between groups 2 and 3, whereas p > 0.05 between groups 1 and 2).

CONCLUSION: This study suggests that smoke inhalation delays the bone

healing in tibial lengthening; however, HBO mitigates the delayed

healing effect of smoke inhalation and, thus, helps the smoking

animal in achieving an expeditious bone healing in tibial lengthening.

PMID: 10528613 [PubMed - indexed for MEDLINE]