[abstract] HBO2, AN EFFECTIVE THERAPY FOR LIMB SALVAGE IN CRUSH INJURIES OF THE EXTREMITIES

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[abstract] HBO2, AN EFFECTIVE THERAPY FOR LIMB SALVAGE IN CRUSH INJURIES OF THE EXTREMITIES

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Title: [abstract] HBO2, AN EFFECTIVE THERAPY FOR LIMB SALVAGE IN CRUSH INJURIES OF THE EXTREMITIES
Author: Matos, LA; Lopez, EA; Sanchez, CA
Abstract: BACKGROUND: The physiologic effects of HBO2 effectively counteract the evolving mechanisms in crush injuries (edema, hypoxia, ischemia/reperfusion) through which progressive tissue loss, infection and amputations occur. In this study we update our experience with a larger clinical series to validate our treatment protocol in the management of crush injuries. METHODS: 33 consecutives patients with Grade III crush injuries treated with adjuvant HBO2 therapy at the University of Miami/Jackson Memorial Medical Center from 1999 to 2002. The patients' injuries were categorized according to the Gustilo classification: Grade IIIA (7), Grade IIIB (23) and Grade IIIC (3). The HBO2 therapy was delivered in a multiplace chamber at 2.36 ATA for 90 minutes on 100percent oxygen, BID and QD schedule. HBO2 was discontinued with the development of a healthy granulation bed or resolution of ischemic changes in tissues. All patients received initial indicated surgical management within 24 hrs. of their injuries. RESULTS: 88percent (29/33) of the patients had a successful outcome with preservation and good functional recovery of the threatened limbs. The high-energy transfer to tissues sustained by most patients were produced by compressive and shearing mechanisms. The average time from injury to initiation of treatments was 48 hours with a mean of 15 HBO2 treatments. Only 48percent of the patients required reconstructive procedures (14 STSG and 2 free flaps) to address the soft tissue defect. All 4 failures underwent amputations (2 transmetatarsal, 2 transtibial). Incidence of soft tissue infection was minimized and osteomyelitis prevented in all cases. CONCLUSION: This study corroborates our findings reported in 1999 and further supports the effectiveness of timely HBO2 therapy in the management of crush injuries to minimize limb loss and additional surgeries. 94percent (16/17) of patients over age 40 had a successful result sustaining the findings by Bouachour et al. in his control study.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/1346
Date: 2003

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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