Flesh Eating Bacteria is Coming to a Town Near You!

Flesh eating bacteria is in the news. Aimee Copeland, the Georgia student who lost her leg to a rare flesh-eating infection after a zip-line injury, knows she’s lucky to be alive, according to her family.

Flesh eating bacteria are a common term to describe what are called Necrotizing soft tissue infections. We have treated a number of these cases over the past year. Several of them were in men in the area of the scrotum, where these poor mens’ testicles swelled up to the size of grapefruits. Fortunately, with surgery and HBOT, we were able to heal these horrible infections.

Necrotizing soft tissue infections are rare, serious, and sometimes life-threatening bacterial infections. Necrotizing fasciitis, or flesh-eating disease, is the most widely known infection of this type. Necrosis means the death of cells and tissue. Skin, muscle, and connective tissue infected with bacteria may suffer hypoxia, or a lack of oxygen, and die.

Flesh-eating disease may be caused by a number of different bacteria, in a single strain or mixed, originating within the body, in chronic or traumatic wounds, or from foreign matter. One increasingly common cause of flesh-eating disease is MRSA, or methicillin-resistant Staphylococcus aureus, which has become a particularly troublesome hospital- and healthcare-acquired infection (HAI).

Hyperbaric oxygen therapy (HBOT) is emerging as an adjunct to traditional surgery and antibiotic therapy for these special kinds of problem wounds. Some of the bacteria involved are anaerobic, meaning they thrive in low-oxygen environments. HBOT inhibits anaerobic and some other bacteria from replicating, spreading, and releasing damaging toxins. Hyperbaric oxygen may also boost the effect of antibiotics, enhance the body’s natural defenses against flesh-eating bacteria, and help resolve or delay the onset of sepsis, a deadly blood poisoning.

So, remember, watch out for any routine infection—you never know when it might be Flesh Eating Bacteria.

HBOT Might Help Wounded Warriors

Check out Video Clip

Healing From Late Effects of Radiation–Video Patient Testimonial (09/28/11)

Things to Know Before You Dive Lake Tahoe

Most Beautiful Clarity for Diving

It’s that time of year, heading for summer, for those of you who want to scuba dive at Lake Tahoe. It is a clear and pristine location to make that easy entry dive. Please remember that the lake is at 6400 ft. elevation and at present there is a lot of cold snow melt.

Keeping this in mind, you’ll need to prepare with high altitude dive tables and use a thick wet or dry suit. Also, think of how you get to the lake. Do you drive or fly there? Did you give yourself time to de-gas from sea level? Are you going to have to go up over a pass to get back to where you are staying? Do you know the symptoms of simple or severe decompression sickness? Include Northern Nevada Hyperbarics, the only facility treating decompression sickness, in your dive planning.

Northern Nevada Hyperbarics is at Renown Medical Center in Reno, NV. We are capable of treating all forms of decompression sickness. We have Sechrist mono place chambers with air-brake capabilities. Our staff has a combined 50+ years of experience.

Contact Frank Irwin (the smiling one in the photo above), safety and dive officer at (775) 826-2084

HBOT Helps With Spider Bites

HBOT can help with the effects of spider bites.

This type of injury has been shown to respond to hyperbaric oxygenation treatments. Necrotizing (flesh eating) effects are a complication of the brown recluse spider and other spider bites which are characterized by progressive necrosis and inflammation of the tissue at the site of the spider bite. Doctors sometimes diagnose this by the signs and symptoms that later develop. How much tissue damage you get is relative to the amount of venom injected, location of the bite (with high fat areas being more severely affected) and the immune status of the patient.

I remember a patient we had several years ago. They ended up in the emergency room with 6 bites on the their lower left leg. Each site had a width of 3 inches of tissue destruction. The plastic surgeon had told the patient that they may have to amputate the leg. Fortunately, the doctor referred the patient to Northern Nevada Hyperbarics and after two weeks of treatment (10 days) the patient was on the road to recovery and the wounds healed nicely.

If you or a loved one ever get into a situation where you get a spider bit and it is not healing get to a doctor immediately. It is a very serious situation. Contact us at (775) 826-2084 if you have any questions. We are here to help you.

Saving Skin Grafts and Flaps

--Diabetic --6 month non-healing wound --One failed graft

Compromised skin grafts and skin flaps stand for a problem involving inadequate oxygen supply to tissue. Skin grafts typically survive as oxygen disperses into them from the original wound bed. Skin grafts can partially or fully have fail when there is not enough oxygen supplied. There are a few types of skin grafts which are: full-thickness grafts where all the layers of skin are used, split-thickness grafts in which only the top layers and some of the deep layers are used, as well as pedicle grafts where part of the skin remains to the donor site. Factors such as age, nutritional status, smoking, and previous radiation result in an erratic pattern of blood flow to the skin.

Hyperbaric oxygen therapy can be used to promote the development in new blood vessels tissues affected by a burn, radiation therapy or in patients with decreased perfusion or hypoxia.

Hyperbaric oxygen therapy is helpful in saving the failing grafts and flaps. However, it can also be used prior to surgery in order to prevent skin grafts and flaps from failing in the first place. Hyperbaric oxygen therapy also reduces swelling of the graft or flap by reducing edema. Hyperbaric oxygen therapy has a success rate of over 75% when dealing in compromised skin grafts and flaps.

< After 25 Tx / 5 Weeks Healthy (beefy / red) granulation tissue

< Then split thickness graft placed 100% acceptance

HBOT Can Help Heal De-Gloving Injuries

HBOT is effective for many types of wounds including de-gloving injuries to various body parts (such as the hand in the example), large surface wounds from trauma, spider bites and many non healing wounds. HBOT decreases tissue swelling and therefore salvages damaged tissues when used in the case of traumatic injuries. In the case of chronic wounds, HBOT assists the epithelium covering the wound and stimulates fibroblast production of collagen.

Protocal:
3 HBOT treatments in first 24 hours. Total of 20 over a period of 4 weeks. Then, healed and most function of the hand restored.

Air Embolism Treatment With Hyperbaric Oxygen Therapy

AIR EMBOLISM

Air embolisms are caused when gas bubbles enter blood vessels. This results in poor blood flow and decreased oxygen delivery to the areas where the blood vessels have been affected. Air embolisms can be fatal or result in serious disabilities. Following an air embolism a person might experience weakness or paralysis in the limbs, loss of vision, heart, lung or brain damage and many other permanent health conditions. Aggressive treatment of air embolism is needed to ensure the best chance of recovery from this disease.

Hyperbaric oxygen therapy has been used to reduce the size of bubbles circulating in blood vessels.

The increased pressure in the hyperbaric chamber makes the bubbles smaller and helps push them back into physical solution, while the high oxygen pressure washes out the gas from the bubble. Once the bubbles are smaller or gone, blood flow resumes.

This allows poorly oxygenated tissues to receive high levels of oxygen. Also, when vessels are obstructed by gas bubbles they leak fluid causing swelling in the surrounding tissues. When blood flow is restored, the swelling subsides, improving blood supply and oxygen delivery even more. Lastly, high amounts of oxygen provided in the hyperbaric chamber support the areas injured by air embolisms while blood flow reduction and tissue swelling are being repaired. Air embolisms are medical emergencies and are treated within a hospital setting.

Carbon Monoxide Poisoning and HBOT

As we approach the winter time in the Truckee Meadows, please consider how to protect you and your family from Carbon Monoxide Poisoning. Carbon Monoxide Poisoning is a leading cause of death by poisoning in the United States. Among causes of Carbon Monoxide Poisoning are automobile exhaust (accidental or purposeful), faulty heaters, and building fires. Hyperbaric Oxygen Therapy is an approved treatment for this serious condition.

Many factors affect the carbon monoxide poisoning symptoms and the outcome of treatment.

Most significant factors are: the inhaled CO concentration, duration of exposure, rate and depth of breathing, heart rate, co-morbid illnesses and most importantly, the time between discovery of the patient after exposure and arrival at a Hyperbaric Chamber.

Carbon Monoxide Poisoning

Stephen R. Thom, M.D., Ph.D., FACEP and Lindell K. Weaver, M.D., FACP, FCCP, FCCM

The injuries caused by carbon monoxide (CO) traditionally have been viewed as due to a hypoxic stress mediated by an elevated carboxyhemoglobin (COHb) level. The two organ systems most susceptible to injury from CO are the cardiovascular and central nervous systems. Human and animal data indicate that major cardiac injury is due primarily to CO-induced hypoxic stress.

However, the COHb level does not correlate well with the development of neurological injuries. Recent investigations have established that systemic oxidative stress can arise from exposure to CO and that perivascular and neuronal injuries arise by mechanisms other than hypoxia. Neuropathology seems to be due to a complex cascade of biochemical events involving several pathophysiologic processes.

Administration of supplemental oxygen is the cornerstone of treatment of CO poisoning. Oxygen inhalation will hasten disassociation of CO from hemoglobin dissociation to occur at a rate greater than that achievable by breathing pure oxygen at sea-level pressure.

Additionally, HBO2, but not ambient pressure oxygen treatment, has several actions which have been demonstrated in animal models to be beneficial in ameliorating pathophysiologic events associated with central nervous system (CNS) injuries mediated by CO.

These include an improvement in mitochondrial oxidative processes, inhibition of lipid peroxidation, and impairment of leukocyte adhesion to injured microvasculature. Animals poisoned with CO and treated with HBO2 have been found to have more rapid improvement in cardiovascular status, lower mortality, and lower incidence of neurological sequelae.

Since 1960, the clinical use of HBO2 for CO poisoning has occurred with increasing frequency. Over 2,500 CO-intoxicated patients were treated in North American hyperbaric chambers in 1992. However, this is only a small fraction of those poisoned with CO. Extrapolation of data from a 1994 survey across three western states projected that over 4,000 CO-poisoned patients are evaluated in emergency departments annually in the United States.

In reported series, clinical recovery among patients treated with HBO2 appears to be improved beyond that expected with ambient pressure supplemental oxygen therapy. This has been observed both in terms of mortality and neurologic morbidity.

This research found that the optimal benefit from HBO2 occurs in those treated with the delay after exposure and that repeat treatments may yield a better outcome than just a single treatment in selected patients.121

Saving Life and Limb! Warning—Graphic Images

I have personally treated numerous patients over the last 11 years with non healing wounds. (Check out the graphic images below) Sometimes, people were one step away from amputation. It is so rewarding to save toes, feet, and whole legs (and other body parts) and to see how we can give back a quality of life that our patients never thought possible.

Do you or someone you know have a non healing wound that stems from vascular insufficiency, a complication after radiation therapy, diabetes, or a problem amputation site? How about a wound that comes from a traumatic injury or one that just won’t heal after surgery?

These wounds could all share the common underlying problem of having a low oxygen level, what doctors call tissue hypoxia usually related to poor circulation. Add to the common problem of low oxygen, tissue inflammation and/or infection and you have the ingredients for what could become a very serious limb or life threatening situation.

Sometimes wounds fail to respond to wound care alone. This happens especially when a person has multiple complicating factors like diabetes or a history of radiation therapy.

Fortunately, when hyperbaric oxygen treatment is used in conjunction with standard wound care, patient outcomes improve substantially. Give us a call and/or tell your doctor that you would like to try hyperbaric oxygen therapy. Contact Richard Flyer, Clinical Director at (775) 826-2084. We offer a free consultation.

Key to Images:
First Row—-Diabetic wound with a bone infection. Healed after 35 treatments (7 weeks)
Second Row—Crush injury to hand. 3 treatments to start for a total of 20 total (4 weeks)
Third Row—-Wound from radiation to the neck. 35 treatments (7 weeks)
Fourth Row—Open wound on knee from radiation. Needed 20 treatments (4 weeks)-graft applied after.