Tuesday, January 22, 2013


Oxygen therapy promises faster healing of wounds

PUNEShyam woke up one day to find the toes of his right leg turning cold and blue. He had diabetes and this was affecting blood circulation to his toes. His doctor amputated the gangrenous toe but the wound would not heal as enough oxygen was not reaching the wound.

At the time when Shyam was afraid that he would not be able to walk, doctors advised him to undergo hyperbaric oxygen therapy (HBOT) that involves breathing pure oxygen.

After a few sessions, he was able to walk and perform routine functions. Shyam is not alone. Patients suffering from non-healing wounds, acute thermal burns, traumatic brain injury, radiation damage to tissues, crush injury, sudden hearing loss and several other conditions are benefiting from this therapy, say experts.

Currently, three hospitals in Pune offer this form of treatment. Among them, KEM Hospital in Rasta Peth launched the facility on Tuesday.

In HBOT, a person lies down in a transparent pressurised hyperbaric chamber and breathes 100% oxygen, pressurized to 1.5 to 3 times the atmospheric pressure. Oxygen molecules dissolve in the plasma (the liquid part of blood) and 10 to 20 times more oxygen reaches all tissues.

"Even where the circulation is poor, adequate oxygen reaches the affected area, new cells are generated and the healing process becomes faster," said Ravindra Patel, founder-president of Innovative Healing Systems (USA and India) that started the advanced wound care and HBOT at KEM hospital.

The centre, equipped with two latest US made hyberbaric chambers, will provide complete wound management support to patients. Doctors trained in HBOT, along with specialist paramedic staff in wound management, will be managing the centre, he added.

"The treatment is non-invasive as all the patient does is lying down in the transparent pressurised hyperbaric chamber and breathe. Each session is 60 or 90 minutes long," Patel said.

The patients are instructed not to wear any perfume, hair oil or jewellery during the HBOT session. They change into cotton clothes and are not allowed to take mobile phones, books or any electronic item into the chambers.

HBOT has also shown great effectiveness in treating conditions such as gas gangrene and carbon monoxide poisoning.

Sancheti hospital was the first in Pune to launch the HBOT facility in 2005-06. "Every month, 30 to 40 patients of non-healing wounds, non-healing fractures, gas gangrene and diabetic foot undergo HBOT at our hospital. The effectiveness of the therapy has been very good all these years," said physician Kiran Kudrimoti who oversees the HBOT facility at Sancheti hospital.

State run Sassoon hospital is perhaps the first government hospital to have the HBOT facility. "We launched the HBOT three years ago. Every month, 20 to 25 patients undergo this therapy at our centre. Among them, three to four are invariably patients suffering from gangrene," said a doctor from the surgery department at Sassoon hospital.

"Recent research has examined the possibility that it may also help in other conditions such ascerebral palsy and multiple sclerosis, but no significant evidence has been found," said a physician from the Sassoon hospital.

HBOT is a well-established treatment for decompression sickness. Other conditions treated with hyperbaric oxygen therapy include serious infections and bubbles of air in blood vessels.

"In a hyperbaric oxygen therapy room, the air pressure is raised up to three times higher than normal air pressure. Under such conditions, your lungs can gather up to three times more oxygen than would be possible while breathing pure oxygen at normal air pressure. Your blood carries this oxygen throughout your body, stimulating the release of substances called growth factors and stem cells, which promote healing," said another doctor.

According to Kurus Coyaji, medical director of KEM hospital, "Advances in medicine are leading to development of effective, non-invasive and patient-friendly technologies. The HBOT is one such option available to people facing difficulty in wound healing."BOX

Hyperbaric oxygen therapy

Hyper means greater and baric means pressure. Hyperbaric oxygen therapy (HBOT) is a mode of therapy in which the patient breathes 100% pure oxygen at pressure greater than normal atmospheric (sea level) pressure.

Why the therapy?

Body's tissues need adequate supply of oxygen to function. When the tissue is injured, it requires even more oxygen to survive. Hyperbaric oxygen therapy increases the amount of oxygen the blood can carry. An increase in blood oxygen temporarily restores normal levels of blood gases and tissue function to promote healing and fight infection.

Hyperbaric oxygen therapy is used to treat a variety of medical conditions, and different institutions use this treatment in different ways. Doctor may suggest hyperbaric oxygen therapy if you have one of the following conditions: Bubbles of air in your blood vessels (arterial gas embolism); decompression sickness; carbon monoxide poisoning; a wound that won't heal; a crush injury; gangrene; skin or bone infection that causes tissue death; radiation injuries; burns; skin grafts or skin flaps at risk of tissue death; severe anemia.

Although research regarding hyperbaric oxygen therapy is under way, currently there's insufficient scientific evidence to support claims that hyperbaric oxygen therapy can effectively treat the following conditions: Allergiesarthritisautismcancer, cerebral palsy, chronic fatigue syndrome, cirrhosis, fibromyalgia, gastrointestinal ulcers, stroke.

How it is done?

* There is a difference in normal breathing and HBOT. In normal breathing, only 21% oxygen is taken in.

* HBOT has a chamber. Inside a person can lie down and breathe 100% pure oxygen. Once patients are made comfortable inside, the chamber is closed.

* Gradually, the air pressure is increased. Patients start breathing pure oxygen at one-and-a-half or two atmospheric level. Which means, our body comes under the pressure which is one-and-a-half or two times more than the normal atmosphere level.

* Oxygen breathed at this level helps wounds to heal. After about 60 or 90 minutes, the patient comes out of the chamber, sweating, thirsty and a little tired, but with lots of life giving oxygen.

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