By Maureen Keshock, M.D.
Hyperbaric oxygen therapy has its roots back to 1662, with the construction of a pressurized room by an English physician named Henshaw. The room was pressurized by bellows that raised the air pressure a few pounds per square inch above ambient pressure.
Patients in hyperbaric treatment nowadays are placed in a chamber where 100% oxygen is circulated. The oxygen is pressurized so that the oxygen level achieved in the body is much higher than normal.
Atmospheric pressure at sea level is 1 ATA or atmosphere. At 1 ATA, the oxygen dissolved in blood is 1.5 ml/dl; at 3 ATA, dissolved oxygen in blood is 6ml/dl. Normal subcutaneous tissue oxygen tension is 30-50 mmhg. Dividing cells in a wound require an oxygen tension of at least 30 mmhg. Tissues in wounds that are not healing have partial pressures of oxygen of 5-20 mmhg. A “dive” of 2.4 atmospheres would result in a wound partial pressure of oxygen of 800-1100 mmhg.
Wounds that fail to heal have low oxygen levels. Hyperbaric oxygen therapy can offer a dramatic difference in wound healing. Especially when combined with a comprehensive wound care evaluation.
Mr. Mankes is a 65 year old diabetic man with bilateral below the knee amputations. He was initially told, by a vascular surgeon, that there was no hope in healing his wounds and recommended bilateral mid thigh amputations. He refused this option and ended up at EMH’s Wound Care Center. His amputation was life disrupting enough, but to comply with that recommendation would have really limited his options.
He has now undergone hyperbaric therapy, antibiotics, and debridement to cure his wounds. “I have been treated at another wound care center, but didn’t see any improvement and the doctors didn’t have the answers.” Mr. Mankes has currently completed about half of his treatment and his wounds have improved 38% since his first visit. “At the EMH Wound Care Center, the Doctors and Nurses listen to what you have to say. The chamber is very comfortable and there is no penned in feeling. It’s nice, easy and relaxed.”
Hyperbaric chambers at EMH have sophisticated features that provide for patient safety and comfort. These are some of the most comfortable chambers in this area and patients are able to watch T.V. or listen to music during treatment. The treatment is supervised by a physician specialist as well as by specially trained nurses and technicians. There is also an intercom to communicate with people outside of the chamber.
The wound care center considers a chronic nonhealing wound to be one that has not demonstrated improvement after 4 weeks. If you’re a diabetic, the evaluation can even be started sooner.