Thursday, September 13, 2012

What Does Diving Have to Do with Wound Care?

When I started working at Meritus Health and heard about hyperbaric tanks, all I could think of was deep sea diving. Turns out I wasn’t that far off. In fact, Meritus Health’s Wound Center was recently awarded accreditation by none other than the Undersea & Hyperbaric Medical Society (only a handful of Maryland hospitals have this accreditation, by the way). And when you overhear Wound Center staff talking about treating a patient, you’re likely to hear something like, “Mrs. Smith will be diving on Tuesday morning.”

So what’s going on? Does hyperbaric oxygen therapy (commonly called HBO) require a wetsuit?

The answer lies in the history of hyperbaric chambers, which were primarily used to treat divers with the “bends,” a decompression sickness. To describe it simply, when scuba divers breathe out of an air tank, they’re breathing a mixture of gasses. As they dive into deeper waters, pressure increases, causing the gasses in their air tanks to dissolve into their tissues. While the human body uses the oxygen that’s breathed in, the nitrogen continues to build up. When the diver moves toward the surface again, the pressure decreases and the nitrogen wants out. If the diver surfaces at the right speed, that’s not a problem. But if he or she surfaces too quickly, the nitrogen comes out as gas bubbles that can block the flow of blood. That’s where things get painful, even deadly.

The HBO chamber helps by recreating a high-pressure environment similar to the pressure the diver was experiencing underwater. In a sense, the patient dives back in so that they can start surfacing again, but at a slower pace that gives their body time to adjust. The HBO chamber also supplies high levels of oxygen, which helps any injured tissues heal.

Around the 1950s, the medical community became increasingly interested in whether HBO chambers could help treat patients suffering from other illnesses or injuries. After all, if extra oxygen helps tissues damaged by nitrogen, why shouldn’t it help tissues injured other ways?

Over time, doctors have experimented with using HBO to treat a variety of illnesses. (Perhaps you’ve heard rumors of celebrities trying to prevent wrinkles by sleeping in a hyperbaric chamber---that one hasn’t panned out.) But the treatment didn’t really take off until insurance companies began to recognize the value of this non-surgical, non-invasive treatment option.

Hyperbaric Treatments Today
Today, HBO is an accepted medical treatment for a variety of medical issues. It’s still used to treat decompression sickness, but in addition, hyperbaric oxygen therapy helps patients with carbon monoxide poisoning, severe anemia, crush injuries, radiation injuries, infections of the soft tissue and bones, thermal burns, skin grafts and flaps, and of course, chronic wounds. Health professionals like HBO because it’s effective. Patients like it because it doesn’t hurt.

Meritus Health Wound Center's hyperbaric chambers
At Meritus Medical Center, the Wound Center can treat any of the problems listed above. Diabetic foot wounds are among the most common medical issues treated there, but the physicians recommend that anyone who has a wound that has not healed in 30 days should see a wound specialist.

By Kathleen McGuire Gilbert

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