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Hyperbaric Oxygen Therapy

An Effective Wound Treatment Method at Touro

Hyperbaric Oxygen Therapy (HBO) consists of breathing 100% oxygen while in an environment of increased atmospheric pressure to increase the amount of oxygen in the tissues. This pressure is measured in atmospheres absolute or ATA. The amount of pressure you will receive during the HBO treatment is 2.0-2.4 ATA, or the equivalent of diving to 33 - 45 feet of sea water.

During the treatment, you will feel pressure changes similar to riding in an airplane. Pressure change is felt in any trapped air space in the body. The pressure in these spaces must be equalized to avoid injury. Our staff will review with you the expected outcomes and potential risks as we develop your treatment schedule. The number of treatments you receive depends on your progress and healing rate.

Effects of pressure change

The change in pressure that you experience during HBO is not dangerous but may cause uncomfortable side effects or unpleasant feelings.

During HBO, you may feel:

  • Ear barotrauma: You will need to equalize the pressure in your middle ears, just like you would if you were riding in an airplane. This can be done by yawning, swallowing or a modified Valsalva maneuver. Our staff will explain these techniques to you. If you experience any pain or discomfort during your treatment, notify the staff immediately to decrease the possibility of rupture to the eardrum.
  • Sinus discomfort: Normally, the sinus passages are open. However, if you are congested, pressure in the sinuses may not equalize, causing discomfort. If necessary, we can give you nasal spray or a decongestant to relieve discomfort.
  • Tooth pain: Normally, patients have no problems with their teeth. However, if you have air trapped under a filling or a tooth abscess, you may experience some discomfort.
  • Temperature changes: At the beginning of each treatment as the hyperbaric chamber is pressurized, it may feel warmer. This pressurization lasts approximately 10 minutes. After the treatment pressure has been reached, the temperature will decrease. At the end of the treatment, pressure is decreased and it will feel cooler. This also lasts approximately 10 minutes.
  • A subconscious impulse to hold your breath: Many patients subconsciously hold their breath while in the chamber. It is important that you DO NOT hold your breath and continue to breathe and talk normally during the pressure changes. Holding your breath during these times could result in the lungs collapsing. High doses of oxygen over an extended period cause damage to lung tissue. The oxygen you will receive is at a low enough dose and over a short enough duration that you should not experience any breathing problems. If you develop chest pain, burning, or have difficulty breathing, please inform the hyperbaric physician or nurse immediately.

Effects of hyperbaric oxygen

In the field of wound treatment, oxygen is considered a drug. As with any other drug or medication, the potential to develop side effects exists.

The hyperbaric oxygen during this treatment may cause you to experience:

  • Oxygen toxicity: At a high enough dosage, oxygen can cause a seizure in some patients. At the dose you will receive, oxygen seizures are extremely rare (less than 1 in 10,000 treatments), but it is important that you understand there is a small chance this may occur.
  • Vision change: Many hyperbaric patients experience a change in vision after two to four weeks of therapy. The oxygen causes temporary nearsightedness. Your vision should return to its previous level two to three months after hyperbaric oxygen therapy is finished.
  • Change in blood sugar: Many patients with diabetes experience a drop in blood sugar during hyperbaric oxygen treatments. We will check your blood sugar before and after each treatment. Be sure to continue with your prescribed diet and medication regimen.

Patient safety

As the chamber you are placed in during HBO is comprised of pure oxygen, fire hazards are taken very seriously.

Strict fire prevention guidelines are followed in the hyperbaric chamber, including:

  • Wearing only the 100% cotton gown provided by the staff
  • Not bringing any petroleum or alcohol-based products into the chamber
  • Not using any cosmetics, oils, lip balms, lotions, hair care products, cologne, perfume, etc. prior to a hyperbaric treatment
  • Not taking lighters, matches, any electronic equipment, or battery operated equipment (watches, hearing aids) into the chamber
  • You may wear your glasses during the treatment.

Visitors are not allowed in the chamber room except at designated times and only under certain conditions. Tours can be conducted and scheduled by a staff member.

Osteoradionecrosis (ORN)
Osteoradionecrosis is a wound healing defect caused by high dosage radiation treatments. ORN occurs when high doses of radiation cause damage to soft tissue and bone. The radiation that is used to kill cancer cells also destroys the normal cells in the surrounding tissue. Cells that form the blood vessels are also affected. This means that tissues that have been exposed to radiation have a very poor blood supply. Any wound created in this area will be unable to heal due to this poor blood supply. The most common contributing factors for ORN are tooth extraction damage or radiated bone.

Hyperbaric oxygen will help your body rebuild blood vessels. This process is called angiogenesis. Angiogenesis can be stimulated through large doses of oxygen. To receive a dose large enough to produce angiogenesis, oxygen must be given under pressure.

How many treatments will I need?

If you have exposed bone or an open wound you can expect:

  • 30 pre-surgery treatments at 2.4 ATA for 90 minutes
  • 10 post-surgery treatments at 2.4 ATA for 90 minutes

If you are expecting to have surgery or dental work done, you can expect:

  • 20 pre-surgery treatments at 2.4 ATA for 90 minutes
  • 10 post-operative treatments at 2.4 ATA for 90 minutes
  • Your doctor may modify your treatment schedule at any time.