SKIN GRAFTS AND FLAPS (Compromised)
Hyperbaric oxygen therapy is not necessary or recommended for the support of normal, uncompromised skin grafts or flaps. However, hyperbaric oxygen is effective in promoting capillary proliferation and granulation to prepare a surgical site. This preparation is essential in patients who require grafts or flaps to cover areas where compromised microcirculation or hypoxia contribute to questionable viability of the transplanted tissue.
RATIONALE: Hyperbaric oxygen therapy can help to maximize the viability of compromised graft or flap tissue following transplantation, thereby reducing the need for repeat surgical procedures.
SOURCE: UHMS Publication CR(HBO) 1996
INTRACRANIAL ABSCESS
Intracranial abscess was added to the list of "approved indications" for HBO by the 1996 UHMS Committee Report. Over the last two decades there has been a gradual drop in mortality to the present 17%. However, certain patients remain problematic at best. These include patients with multiple abscesses and/or deep or dominant abscesses, patients who are compromised hosts, patients in whom surgery is contraindicated, and patients unresponsive to standard surgical and antibiotic regimens. Here HBO plays a role. Although only 20 patients have been reported, there is a 0% mortality. This is a remarkable finding. As a result, patients meeting these criterion should be seriously considered for HBO therapy.
SOURCE: UHMS Publication CR(HBO) 1996
EXCEPTIONAL BLOOD LOSS (Anemia)
Exceptional blood loss anemia occurs when the patient has lost sufficient red cell mass to compromise respiratory requirements and cannot or will not receive transfusions because of medical or religious reasons.
RATIONALE: The intermittent use of hyperbaric oxygen therapy will supply enough oxygen in the severely anemic patient to support the basic metabolic needs of the respective tissues of the body until red blood cells are restored. Most vitally, our brain requires a supply of 6 volumes percent of oxygen to support its basic metabolic requirements. Hyperbaric oxygen at 3 ATA will place 6 volumes percent of dissolved oxygen in an intravascular acellular perfusate. Thus, hyperbaric oxygen is a valuable adjunct when used early in treating acute blood loss in those who cannot receive blood replacement for medical or religious reasons.
SOURCE: UHMS Publication CR(HBO) 1996