Hyperbaric oxygen therapy (HBO) is an adjunctive therapy. Certain conditions must be met before HBO will contribute to wound healing. Among these are:

• Systemic diseases such as diabetes must be adequately treated
• Nutritional needs must be met
• Nicotine intake must be curbed
• Contraindications and risks must be considered
• Treatment for infection should be instituted
• Major blood vessel flow must be present
• Aggravating factors to the wound such as local pressure or irritation should be minimized
• Wound debridement concurrent with HBO therapy is necessary
• Sufficient HBO treatments must be undertaken before efficacy of treatment is assessed

Features of Our HBO Service
1. Referring physician remains the patient’s physician. He/She also assesses efficiency of treatment by these observations:

• Inflammation should diminish and wounds assume a noninfected appearance. (The antibacterial effect of HBO is not covered in this brochure.)
• Treatments should increase areas of granulation tissue in the wound.
• Wound edges become better defined and wound size begins to decrease.
• During preparation for and salvage of a compromised graft, deterioration of the site should be arrested and appearances occur as above.

2. HBO is used in conjunction with other treatments.

3. Certified HBO physicians and respiratory therapists in attendance during treatment.

4. A series of photographs of lesions are always taken to monitor treatment.

5. The hyperbaric chamber is large enough to accommodate up to six patients comfortably in addition to a therapist, who accompanies patients on all treatments.

6. Our Hyperbaric Medicine Service has experience with more than 8,500 treatments. Results of wound healing have been consistently satisfactory.

Typical Treatment Regime with Minimal Number of Treatments
A standard treatment uses 100 percent oxygen (with air breaks) at 2.4 atmospheres for 90 minutes.

• Wounds and grafts - a minimum of 20 treatments is recommended. Post operative treatments may be indicated when necessary
• Prevention of osteonecrosis for tooth extraction in irradiated areas - 20 treatments, extraction - 10 treatments.
• Healing of oro-cutaneous fistula - 30 treatments
• Augmentation of elective-maxillo-facial reconstruction - 20 treatments, surgery - 10 treatments
• Treatment of osteoradionecrosis of mandible- Marx-Univ. of Miami Protocol - Stages II, III, IIIR - 20 treatments - Surgery - 10 treatments
• Healing of tissue radionecrosis - areas other than head and neck -a minimum of 20 treatment

Referring a Patient and Preliminary Work-Up
If you have questions or would like to refer a patient call 319-356-8220 or call UI Hospitals and Clinics' information at 319-356-1616. Ask for the hyperbaric medical doctor.

HBO in the following conditions are recognized for reimbursement by third party payors^†D:

• Preparation of a site for a skin graft
• Preservation of a compromised skin graft
• Necrotizing infection*
• Soft tissue radionecrosis.
• Osteoradionecrosis
• Chronic refractory osteomyelitis

† Also listed are crush injuries, acute traumatic ischemia, acute peripheral    arterial insufficiency.
D Other indications for HBO are not listed.
* Interpretation of this term available on referral