Hyperbaric Oxygen Treatment (HBOT) for Healing Wounds
HBOT has for long been used for treating decompression sickness, gas gangrene, and carbon monoxide poisoning. It is finding wider application in the quick healing of severe wounds in people with diabetes, burn injuries, crush injuries and healing of skin grafts among others.
Keeping pace with the latest developments, MV Hospital for Diabetes &Prof.MViswanathan Research Centre will soon be the first hospital in Tamil Nadu to offer this facility.
Diabetes and Infections:
People with diabetes tend to get infections more often and with greater severity than those without diabetes. Certain tissues in people with diabetes are more prone to infection because of hyperglycemia, nerve damage, vascular disease and susceptibility to infections.
Nerve damage can change the pressure distribution on load bearing parts, especially the feet. Along with the lack of sensation, this can lead to the formation of ulcers which in turn can get infected.Nerve damage also results in retention of urine in the bladderwhich can predispose to infection of the urinary tract.
Due to vascular disease, there is less blood supply to various tissues. As a result, the amount of oxygen available to the cells is reduced. This lowers the body’s resistance to infections and also allows anaerobic microorganisms to multiply. In Type 1 Diabetes Mellitus, the immune system is altered and this sets the stage for certain infections.
High levels of blood glucose predispose people with diabetes to bacterial and fungal infections as bacteria and fungi flourish in this medium.This also weakens the immune response.
People who have had diabetes for a long time are very susceptible to infectionsof soft tissues and the skin.
It is a vicious cycle in which infection raises the levels of blood glucose, which in turn make the infection worse.
Prevention and Treatment of Infections:
Steps taken to prevent infections in people with diabetes focuses on the factors that cause it - primary prevention of infection, tackling the cause of diabetes, controlling blood glucose levels, and preventing neurological and vascular disease.
The aim of these preventive techniques is to keep the blood glucose and glycosylated hemoglobin levels as close to normal as possible, and considerably reduce the risk of complications.
Managing infections in people with diabetes is different from those without diabetes. When people with diabetes get infections, antibiotics aregiven early and used for a longer time along with other medications.
New Techniques in Wound Healing:
Over the past two decades there have been many new approaches to promote a more rapid healing in diabetic foot lesions. Of these, the Hyperbaric Oxygen Treatment(HBOT) uses oxygen at a level 2 – 2 ½ times greater than atmospheric pressure to heal severe wounds, especially in the lower limbs. In people with diabetes, vascular disease results in less oxygen to the tissues. HBOT raises the levels of oxygen in the plasma which in turn provides more oxygen to the tissuesso thatwounds can heal effectively.
It also increases the effectiveness of leucocytes, is harmful for some anaerobic bacteria and prevents toxin formation in others.
HBOT requires a pressure chamber made of rigid or flexible material and a means of delivering 100% oxygen.
A monoplace chamber compresses one person at a time, usually in a reclining position . Employees tend to the patient from outside the chamber and equipment remains outside the chamber.
Multiplace chambers treat multiple patients at the same time, generally with a nurse or another inside observer who monitors the patients and assists with equipment manipulation or emergencies.
The patient stays in the chamber for about 60 – 90 minutes, breathing in pure oxygen.
A schedule is drawn up according to the needs of the patient and introduced and monitored by trained personnel. Depending on the type and severity of the infection, 10-20 sittings are required which can be taken once a day or sometimes even twice a day.
HBOT has been widely used for the management of non-healing diabetic foot ulcers in the USA for many years.
Benefits of HBOT for People with Diabetes:
• In people with Type 1 diabetes, it increases muscle oxygenation and immune response.
• People with diabetes with complications of the lower extremity, and those with acute peripheral ischemia benefit from this treatment.
• Diabetic Foot- In cases where a combination of vascular ischemia and infection may lead to gangrene, HBOT is used as additional treatment along with antibiotics.
• Gangrene- The absence of or limited arterial blood supply to the limb can cause gangrene. HBOT can help stop further progression of gangrene and limit the rate of amputations.
• HBOT puts an end to soft tissue and bone infections by killing microorganisms, improving leucocyteand macrophage function and enhancing the effect of microbials.
Drawbacks:
It is expensive and time consuming.
Source:
1. RSSDI Textbook of Diabetes Mellitus. Edited by –MMS Ahuja, BB Tripathy, Sam GP Moses, HB Chandalia, AK Das, PV Rao, SV Madhu.
2. International Textbookof Diabetes Mellitus.- 3rd Edition, Vol.2., Editors-in –Chief- RA Defronzo, E. Ferrinnini, H Keen, P Zimmet
HBOT has for long been used for treating decompression sickness, gas gangrene, and carbon monoxide poisoning. It is finding wider application in the quick healing of severe wounds in people with diabetes, burn injuries, crush injuries and healing of skin grafts among others.
Keeping pace with the latest developments, MV Hospital for Diabetes &Prof.MViswanathan Research Centre will soon be the first hospital in Tamil Nadu to offer this facility.
Diabetes and Infections:
People with diabetes tend to get infections more often and with greater severity than those without diabetes. Certain tissues in people with diabetes are more prone to infection because of hyperglycemia, nerve damage, vascular disease and susceptibility to infections.
Nerve damage can change the pressure distribution on load bearing parts, especially the feet. Along with the lack of sensation, this can lead to the formation of ulcers which in turn can get infected.Nerve damage also results in retention of urine in the bladderwhich can predispose to infection of the urinary tract.
Due to vascular disease, there is less blood supply to various tissues. As a result, the amount of oxygen available to the cells is reduced. This lowers the body’s resistance to infections and also allows anaerobic microorganisms to multiply. In Type 1 Diabetes Mellitus, the immune system is altered and this sets the stage for certain infections.
High levels of blood glucose predispose people with diabetes to bacterial and fungal infections as bacteria and fungi flourish in this medium.This also weakens the immune response.
People who have had diabetes for a long time are very susceptible to infectionsof soft tissues and the skin.
It is a vicious cycle in which infection raises the levels of blood glucose, which in turn make the infection worse.
Prevention and Treatment of Infections:
Steps taken to prevent infections in people with diabetes focuses on the factors that cause it - primary prevention of infection, tackling the cause of diabetes, controlling blood glucose levels, and preventing neurological and vascular disease.
The aim of these preventive techniques is to keep the blood glucose and glycosylated hemoglobin levels as close to normal as possible, and considerably reduce the risk of complications.
Managing infections in people with diabetes is different from those without diabetes. When people with diabetes get infections, antibiotics aregiven early and used for a longer time along with other medications.
New Techniques in Wound Healing:
Over the past two decades there have been many new approaches to promote a more rapid healing in diabetic foot lesions. Of these, the Hyperbaric Oxygen Treatment(HBOT) uses oxygen at a level 2 – 2 ½ times greater than atmospheric pressure to heal severe wounds, especially in the lower limbs. In people with diabetes, vascular disease results in less oxygen to the tissues. HBOT raises the levels of oxygen in the plasma which in turn provides more oxygen to the tissuesso thatwounds can heal effectively.
It also increases the effectiveness of leucocytes, is harmful for some anaerobic bacteria and prevents toxin formation in others.
HBOT requires a pressure chamber made of rigid or flexible material and a means of delivering 100% oxygen.
A monoplace chamber compresses one person at a time, usually in a reclining position . Employees tend to the patient from outside the chamber and equipment remains outside the chamber.
Multiplace chambers treat multiple patients at the same time, generally with a nurse or another inside observer who monitors the patients and assists with equipment manipulation or emergencies.
The patient stays in the chamber for about 60 – 90 minutes, breathing in pure oxygen.
A schedule is drawn up according to the needs of the patient and introduced and monitored by trained personnel. Depending on the type and severity of the infection, 10-20 sittings are required which can be taken once a day or sometimes even twice a day.
HBOT has been widely used for the management of non-healing diabetic foot ulcers in the USA for many years.
Benefits of HBOT for People with Diabetes:
• In people with Type 1 diabetes, it increases muscle oxygenation and immune response.
• People with diabetes with complications of the lower extremity, and those with acute peripheral ischemia benefit from this treatment.
• Diabetic Foot- In cases where a combination of vascular ischemia and infection may lead to gangrene, HBOT is used as additional treatment along with antibiotics.
• Gangrene- The absence of or limited arterial blood supply to the limb can cause gangrene. HBOT can help stop further progression of gangrene and limit the rate of amputations.
• HBOT puts an end to soft tissue and bone infections by killing microorganisms, improving leucocyteand macrophage function and enhancing the effect of microbials.
Drawbacks:
It is expensive and time consuming.
Source:
1. RSSDI Textbook of Diabetes Mellitus. Edited by –MMS Ahuja, BB Tripathy, Sam GP Moses, HB Chandalia, AK Das, PV Rao, SV Madhu.
2. International Textbookof Diabetes Mellitus.- 3rd Edition, Vol.2., Editors-in –Chief- RA Defronzo, E. Ferrinnini, H Keen, P Zimmet
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