Amputation and Wound Management Using HBOT
The role of hyperbaric oxygen therapy is usually adjunctive. The importance of coordinated comprehensive care , accurate diagnostic evaluation, and a rationally thought out Hyperbaric treatment plan with properly timed surgical intervention is critical to success.
HBO treatment is very effectively used in preventing or forestalling major amputations in diabetic patients and wound management. Limb salvage rates of 70 to 80 % with associated cost savings, decreased morbidity and mortality, as well as improved quality of life are typical in most hyperbaric facilities.
The application of timely hyperbaric medical management in patients with limb threatening diseases is both rational and appropriate.
While it may sound obvious, good hyperbaric medicine starts with good medicine. This implies an adequate database, a comprehensive history and complete physical examination, and the coordination of available information from outside sources. Only then can an accurate picture of the patient’s problem be made. This work, while occasionally tedious, frequently pays large benefits. It allows one to be able to adequately document justifications for hyperbaric treatment to insurers, identify areas where hyperbaric treatment options may not have been explored thoroughly and allows patients the opportunity to reinvest energy in their own care.
The goal of providing optimal wound healing and limb salvage cannot be accomplished solely by the hyperbaricist. A comprehensive approach, provided by a cohesive team of health care professionals, including the vascular surgeon, the intervention list, the subspecialists in internal and vascular medicine, infectious disease, podiatry, orthopedics, endocrinology, critical care, nutritional medicine and rehabilitation, physical therapy, radiology, plastic and general surgery, and the devoted nursing staff is required for achieving excellent outcomes.
It is the role of the hyperbaricist in a Hyperbaric Facility to prevent unnecessary amputation. Proper selection of patients who can best benefit from hyperbaric oxygen therapy is critical to ongoing growth and success of limb salvage programs or wound management.
Information for this article has been taken from Hyperbaric Medicine Procedures – the Kindwall HBO Handbook by Aurora St. Luke’s Medical Center.