Hyperbaric Oxygen Therapy in the Treatment of Necrosis and Gangrene

摘要: Historically, hyperbaric oxygen therapy has been used for treatment of decompression sickness in deep-sea divers. Today, is commonly the wide variety surgical and non-surgical conditions, persuasively proved its high clinical efficiency many areas. Currently, established indications include different bacterial (mostly anaerobic) fungal infections, arterial gas embolism, poorly healing diabetic wounds , osteomyelitis, radiation tissue injury, carbon monoxide poisoning, crush injuries, gangrene, brain abscesses, burns, skin grafts or flaps at risk compromised perfusion, severe anemia, also conditions like long-standing neurologic deficit, cerebral palsy autism, more. The existing trend ever-expansion to previously untouched areas holds decades. purpose this review examine advantages disadvantages therapy, explore underlying physiological mechanisms actions ischemic, necrotic otherwise tissues. This will mostly be focused on discussion efficacy practical approach HBOT use types gangrene necrotizing fasciitis. Role place ischemic chronic ulcers explored. With currently recommended clinically tested protocols using contemporary equipment, administration generally considered very safe. However, it not absolutely innocuous, certain contraindications, ranged from medical problems physical abnormalities, while relative, should carefully every case. only absolute contraindication untreated tension pneumothorax. Other contraindications include: 1. Severe obstructive pulmonary disease with dioxide 2. retention, blebs, and/or dyspnea slight exertion; restrictive airway (possibility air trapping barotraumas ensued) 3. Optic neuritis 4. Acute viral infection 5. Congenital spherocytosis 6. Uncontrolled, acute seizures disorders 7. Upper respiratory tract 8. Uncontrolled fever