Radiation necrosis (bone / soft tissue)
(Osteoradionecrosis / Soft tissue radionecrosis)
The uninfected necrosis of irradiated bone, especially
in the head and neck, can cause intolerable disability and pain, leading
to disfiguring resections and difficulty in seating grafts and prostheses.
HBO has been clearly demonstrated to improve bone formation, prevent the
occurrence and recurrence of osteoradionecrosis at the time of dental
or facial surgery, and to improve the survival of grafts and protheses.
There is evidence that it assists in the distressing symptom of xerostomia,
which also arises from irradiation. HBO also promotes the resolution of
radiation-induced cystitis and colitis, with pelvic tumours.
Recently a trial in the USA looking into using HBO for the treatment of
radiation induced proctitis (HORTIS) showed that after 6 weeks, 53% of
patients treated with HBO had improved compared to 22% of patients in
the study group.
More
info>>>>
Bone Infections (Refractory osteomyelitis)
HBO is used as an adjunct to antibiotics, debridement,
nutritional support and reconstructive surgery in cases of superficial,
localized and diffuse refractory osteomyelitis.
In refractory osteomyelitis, bones do not heal despite adequate antibiotic
therapy due to tissue hypoxia. New bone formation is an oxygen dependent
process. HBO raises bone oxygen tensions which results in an improvement
in osteoblast and osteoclast activity. This improves new bone formation,
which can result in a resolution of the refractory osteomyelitis.
More
info>>>>
Failing skin grafts
Most skin grafting is successful due to surgical selection
and technical skill. However, ischaemia may arise in a graft or flap due
to decreased microcirculation and underlying tissue hypoxia. Early recognition
of a problem can lead to rescue of at least part of a failing graft by
raising oxygen tensions. Angiogenesis between the graft and its base is
promoted by accelerated collagen formation. HBO maximizes the viability
and final functional level of the compromised nerve and muscle tissue.
More
info>>>>
Failing skin flap
Failing skin graft