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A presentation containing information about Hyperbaric Oxygen Therapy & its benefits.

A presentation containing information about Hyperbaric Oxygen Therapy & its benefits.

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Northern Nevada Hyperbarics Presentation Presentation Transcript

  • 1. Northern Nevada Hyperbarics, Inc. Serving the Community for over 10 Years
    • (775) 826-2084
    • Center for Advanced Medicine - B 1500 E. Second St., Ste. 104 www.nevadahyperbarics.com
  • 2. What is HBOT?
    • 100% oxygen in an enclosed chamber at higher-than-atmospheric pressure where oxygen dissolves in arterial plasma in increased amounts---up to 10 to 15 fold increase.
    • Typical course consists of 30 or more treatments done daily for six weeks.
  • 3. Some Basics
    • HBOT has been used in chronic wounds for about 40 years.
    • 100% oxygen is delivered to a chamber under high pressure (2 to 2.4 ATA) for 90 minutes
    • Typical HBOT treatment course consists of 30 or more treatments daily—M-F
    • Administering oxygen to hypoxic tissue shown to activate fibroblast proliferation, down-regulate inflammatory responses, cytokines, up-regulate growth factors – all proxies for wound healing.
  • 4. Our State-of-the-Art Facility
  • 5. 5 Sechrist Monoplace Chambers Safe & Secure Oxygen Farm
  • 6. Courteous & Professional Staff Janet Albright, MD, FACS Medical Director Richard Flyer, MS Clinic Director And Staff of Certified Hyperbaric Technologists
  • 7. Clinical Hyperbaric Oxygen Therapy Clinical HyperbaricOxygen Therapy
    • Scheduled Indications
    • Non-Healing Diabetic and problem Wounds
    • Radiation soft tissue necrosis, cystitis, and proctitis.
    • Osteoradionecrosis
    • Osteomyelitis
    • Emergency Indications
    • Acute Traumatic Ischemia
    • Crush Injuries and
    • Compartment Syndrome
    • Carbon Monoxide Poisoning
    • Gas Gangrene
    • Surgical Infections
    • Failed Flaps and Grafts
    • Diving Injuries
  • 8. Primary Mechanisms
    • Hyper---oxygenation
    • Vasoconstriction—reduce inflammation
    • Microbiological effects
    • Activate fibroblast and collagen synthesis
  • 9. Secondary Mechanisms
    • Angiogenesis
    • Osteogenesis
    • WBC Oxidative Killing
    • Cell wall permeation
  • 10. Cumulative Effects
  • 11. Vascular Density in Response to Hyperbaric O2 Response to 20 x 1ATA 100% O2 Response to 20 x 2.4ATA 100% O2 8 x increase in vascular density
  • 12. Vascular Density Increase No HBO Start HBO 18 Tx 24 Tx
  • 13. Diabetic Wound w/ Recalcitrant Osteomyelitis
      • Pre-Hyperbaric
      • Partial Wound Closure
      • 20 HBO2 TX---4 Weeks
      • Complication Resolved
      • Full Healing
      • 35 HBO2 TX
      • 7 Weeks
    78 Y.O Male/ 2 Wks Resection Bone / Continued Drainage
  • 14. Problem Wound w/ Skin Graft Failure
    • u
    After 25 Tx---5 Weeks---beefy, red, healthy granulation tissue Split thickness graft placed--- 100% take 58 Y.O. Female / Diabetic / 6mo. Non-healing / 1 Failed Graft
  • 15. Tissue Necrosis in Diabetic Foot
    • After 15 Tx—2 Week
    • Granulation tissue
    Required incision, drainage, and debridement After 20 Tx---3 Week After 30 Tx---4 Week 69 Y.O. Diabetic Female / with Exposed Tendon
  • 16. Non-Healing Post Amputation Initial Visit After 10 Tx After 16 Tx After 34 Tx 46 Year-Old Diabetic Male
  • 17. Achilles Tendon Repair Site After 10 tx’s After 25 tx’s
  • 18. Problem Wound Non-healing suture line 3 months post Healing after 25 HBO TX Medial View Non Healing Transmetatarsal Amputation
  • 19. Left Mandibular Osteoradionecrosis Initial Visit - Bone Exposed Tx 12 - 2 Weeks Tx 25 - 5 Weeks Tx 39 - 8 Weeks New skin over bone 45 Y.O. Male / Radical Neck Dissection / Radiation / Exposed Bone
  • 20. Radiation Soft Tissue Necrosis After 8 Tx—2 Weeks After 36 Tx---7 Weeks After 18 Tx---4 Weeks 52 Year-Old Male w/ Post-Radical Neck Reconstruction Wound Dehiscence & Flap Compromise
  • 21. Radiation Necrosis w/ Incision Dehiscence 12 TX 21 TX 36 TX Three weeks post tx 51 Year-Old Female w/ Neck Dissection
  • 22. Soft Tissue Radiation Necrosis 40 Y.O. Male post T-cell Lymphoma—Rt. hand Initial Visit Tx 7---1 Week Tx 24---5 Weeks Tx 50---10 Weeks No need for graft
  • 23. Graft Placement Post-Radiation Necrosis 2 Months Post-Surgery After 20x HBOTs 10 Days After Spilt Thickness Graft
  • 24. Crush Injury
    • decreased perfusion or hypoxia
    • » HBO at
    11 Weeks after Surgery---Full Range of Motion 3 Tx in first 24hrs. Then total of 20 over a period of 4 weeks. Avulsion of the Palmar Skin
  • 25. Traumatic Ischemia of a Replanted Leg
    • Microvascular reattachment of nerves and arteries
    3 days after surgery—and 6 Tx, Then 4 more Tx over 3 days After 12 weeks, sensate leg--- can walk and run with the aid of brace. 4 Year-Old Mid-Calf Amputation from Lawnmower
  • 26. Healing Compromised Flap of Tibia Fracture
    • Necrosis and
    • breakdown of
    • tissue over plate
    • and bone
    After 10 Tx--- 1 Week---compromised portion of flap is now viable After 20 Tx---3 Week— 100% flap survival 54 Year-Old Male w/ Tibia Fracture and Internal Fixation
  • 27. Failed Flap - Left Dorsal Foot Tx 1 Tx 30---5 Weeks Tx 18---3 Weeks Tx 12---2 Weeks Follow-Up 3 Weeks Final Follow-Up 50 Year-Old Female w/ Degloving Accident
  • 28. Healing Burns A C B D A) 12 hrs after injury B) 24 hrs & 2x HBOTs C) 24 hrs & 2x HBOTs D) Shortly before discharge 23 YO Female w/ Facial Burns From Flaming Gasoline
  • 29. Failed Flap – Right Knee Tx 9—Two Weeks Tx 16---3 Weeks Initial Visit 62 Y.O. Female w/ Failed Flap Post Total Knee eplacement
  • 30. Lip Reimplantation Re-attached wound looked ischemic and swollen. Patient started hyperbarics and antibiotics. After 10Tx Follow-up: Happy Smile 10 Year-Old Female w/ Full Thickness Lesion From a Dog Bite
  • 31. Side Effects of HBOT
      • Claustrophobia / Confinement Anxiety
      • Barotrauma
      • Reversible Myopia
  • 32. Contraindications
    • Absolute:
    • Untreated Pneumothorax
    • Cis-Platin; Doxorubicin; Disulfiram
    • Relative:
    • Emphysema with CO 2 Retension
    • Emphysema w/ Air Trapping
    • Pulmonary Lesion in CXR
    • Uncontrolled High Fever
    • Claustrophobia
    • Seizure Disorder
    • Malignant Disease
  • 33. Insurance
    • Contracts / Agreements with:
    • HHP
    • Senior Care Plus
    • Blue Cross
    • Aetna
    • CIGNA
    • Senior Dimensions
    • Universal Health Network
    • Principal Financial
    • Nevada Preferred Professionals
    • Humana
    • Regence Blue Cross Blue Shield
    • Wellcare
    • Tri-Care
    • Medicare and Medicaid (through our partnership with Renown Health)
  • 34. How To Consult or Refer
    • Call us 24/7 at (775) 826-2084
    • or Visit Us at
    • www.NevadaHyperbarics.com
    • We do most pre-authorizations for you!