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HBOT Helps With Spider Bites

By · April 4, 2012 · Filed in HBOT · No Comments »

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

By · March 21, 2012 · Filed in HBOT · No Comments »

--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

By · March 14, 2012 · Filed in HBOT · No Comments »

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

By · January 11, 2012 · Filed in HBOT · No Comments »

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.

Skin Grafts and Flaps and HBOT

By · November 9, 2011 · Filed in HBOT · No Comments »

A skin graft is a transplanted tissue without its blood supply which is transferred during skin grafting surgery, a type of surgical grafting where transplantation of skin is performed. A graft consists of a section of skin including epidermis and dermis of variable thickness that has been completely separated from its blood supply and transplanted to a recipient bed.

Reconstructing complex wounds is accomplished by shifting or transferring tissues to the wound from a different part of the body. The area from where the skin is borrowed is called the donor site.

Skin Grafts Categories
There are two general categories of grafts in regards to a thickness: full thickness and partial thickness grafts. A full thickness grafts contains the dermis and the epidermis. A partial thickness skin graft includes the epidermis and only a small portion of the dermis. The split thickness skin grafts range from 1/1,200 to 1/2,000 of an inch in depth. Thicker grafts are less prone to wound contracture. In general, full thickness grafts are used in places where less wound contraction is desired, such as the face.

Skin Graft Donor Site

Skin Graft Donor Site – Hyperbaric Oxygen Therapy, Skin Burns
Photo courtesy of “Burned Leg”
Skin Graft Survival

Skin grafts survive as oxygen and nutrients diffuse into them from the underlying wound bed. Long-term survival depends on a new blood supply forming from the wound to the graft. When the wound bed does not have enough oxygen supplied to it, the skin graft will at least partially fail.

Common causes for this are previous radiation to the wound area, diabetes mellitus, and certain infections. In these situations, the availability of oxygen in the wound bed can be increased with hyperbaric oxygen therapy (HBO2) in preparation for skin grafting. Additionally, HBO2 can be used after skin grafting to increase the amount of the graft that will survive in these compromised settings.

Skin Graft

Skin Grafts – Hyperbaric Oxygen Therapy, Skin Burns
Photo courtesy of Minimole

Once the graft has been harvested, it becomes separated from its blood supply and must revascularize to survive. The vascular bed is recreated in a three-step process: imbibition, inosculation, and revascularization. Imbibition occurs in the first 24 to 48 hours. During this phase, the nutrients diffuse from the underlying wound bed to extracellular fluid and into the capillaries of the graft.

The graft begins to fix to the wound bed via fibrin bonds. Inosculation involves the alignment of the donor vascular buds with graft capillaries and establishment of circulation. Revascularization occurs when connecting vessels differentiate into arterioles and venules. Thicker grafts demand more blood supply and require a well vascularized recipient bed to survive. Wounds with exposed bone, tendon, or cartilage or with radiation damaged tissue offer a poor vascular bed.

There are several reasons for graft failure. The most common cause is loss of contact with the recipient bed because of hematoma, seroma, purulent material, and shearing. Meshing the graft helps to overcome the problem of fluid buildup underneath it. Shearing is caused by movement of the graft against the wound bed. This can be prevented by tie-down compression dressings created by interrupted sutures along the edge of the wound. The ends of the suture are left long in order to tie down a nonadherent dressing on top of the graft. The second most common cause of graft failure is infection. Wounds colonized with more than 1 ยช 105 bacteria per gram of tissue will be less likely to support a graft.

Partial thickness skin grafts are most commonly harvested with the use of a dermatome, which is air driven or electric. Dermatomes can be adjusted for depth of cut as well as width of the skin graft desired. Full thickness grafts are commonly acquired by hand with a scalpel.The incision is made in an elliptical fashion to facilitate wound closure. Securing the skin graft to the recipient bed can be accomplished using staples placed along the circumference of the graft. In addition, interrupted chromic sutures can be placed within the graft to anchor it to the wound bed.

Non-adherent dressing as well as sterile absorbent gauze are then placed, and the dressing is left on for 5 days for split thickness grafts and 7 to 10 days for a full thickness grafts. Healing of a split thickness donor site results from epithelialization from epidermal appendages, such as hair follicles, sweat glands, and sebaceous glands that are left behind after the graft is taken. Healing occurs best in an environment that is moist and free from injury and contamination. The process may take up to 21 days. Full thickness donor sites leave no dermis or epidermal appendages behind and, therefore, must be closed primarily or left open to granulate and contract.
Skin Flap

A skin flap differs from graft in that it is a section of tissue that comes with its original blood supply. The blood supply of the flap is referred to as the pedicle. There are several Types of skin flaps:

* Local flap. When the skin flap is from an area close to the wound, for example, a wound on the lip may be repaired by a flap from the adjacent cheek.
* Regional flap. When the skin flap is not from the adjacent area, but is from the same region of the body, for example, a wound on the tip of nose might be repaired with a flap from the forehead.
* Distant flap. When a flap is from a different part of the body, for example, a wound on the hand might be repaired with a flap raised in the groin. A local flap repair is usually done in one operation, whereas regional and distant flaps need two or more operations. The second operation is needed to detach one end of the flap at the donor site, when the blood vessels have developed at the other end.
* Free flap. This is a distant flap, but the whole procedure is done in one stage by repairing the donor and blood vessels by microsurgery.

Skin Flap

Skin Flap

Skin Flaps also require oxygen and nutrients to survive. The outer, visible portion (usually skin) is furthest from the source of blood supply for the flap. This is the area most likely to be compromised by inadequate oxygen.

Factors such as age, nutritional status, smoking, and previous radiation result in an unpredictable pattern of blood flow to the skin. If a flap is found to have less than adequate oxygen after it has been transferred, HBO2 can help to minimize the amount of tissue which does not survive and also reduce the need for repeat flap procedures.

Hyperbaric Oxygen Treatment is neither necessary nor recommended for the support of normal, uncompromised skin flaps and grafts. However, in tissue compromised by irradiation or other cases where there is decreased perfusion or hypoxia, HBO2 has been shown to be extremely useful in flap salvage. Hyperbaric oxygen can help maximize the viability of the compromised tissue thereby reducing the need for regrafting or repeat flap procedures. A number of studies have shown the efficacy of HBO2 on enhancement of flap and graft survival in a variety of experimental and clinical situations.

Hyperbaric Oxygen Therapy for Osteoradionecrosis (bone death)

By · July 26, 2011 · Filed in HBOT · No Comments »

People in the old days just didn’t know the consequences of smoking.—

I thought I would share this story about a doctor who learned his mother was being treated with HBOT for radiation to her jaw. “I live a long ways from the rest of the family. I grew up….MORE

Do You Have a Wound That Won’t Heal?

By · May 20, 2011 · Filed in HBOT · No Comments »

Hyperbaric Oxygen Therapy has been around along time, effectively speeding the bod’s ability to heal itself.

Oxygen is an essential nutrient that is required for healing. Sometimes the body has some underlying issues that keep it from getting enough oxygen. For example, we treat many patients with foot wounds. One of the reasons for a foot wound not healing is underlying diabetes. Diabetes causes problems with the circulation of blood and thus oxygen to the lower extremities. HBOT can artificially elevate the amount of oxygen and get diabetic wounds back on the road to healing. Another example are complications from radiation therapy. In rare instances the radiation used to treat cancer causes collateral damage to healthy tissue. HBOT can help rebuild the blood vessels that might have been damaged.

More on these conditions later.

Richard Flyer
Clinic Director

Northern Nevada Hyperbarics Social Media Up

By · May 12, 2011 · Filed in HBOT · No Comments »

Hi everyone:
Northern Nevada Hyperbarics has upgraded its website and connected a Facebook Fan Page (please “like” us) and a Twitter Feed. We will also continue to blog about topics related to Hyperbaric Medicine and we even have a section where you can ask questions.

While you are at it check out our brand new facility and our wonderful staff tour.

Thanks,
Richard Flyer
(775) 826-2084

Welcome to the Northern Nevada Hyperbarics Blog

By · April 11, 2011 · Filed in HBOT · No Comments »

Welcome to the new Northern Nevada Hyperbarics blog, coming to you from Reno, Nevada. We were the first to start Hyperbaric medicine (HBOT) in the Reno/Northern Nevada area back in 2000. Read More

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