Article – 1 - Thermal Burns
Title: Adjunctive Hyperbaric Oxygen Reduces the Need for Surgery in 40-80% Burns.
Authors: Cianci, PE; Lueders, H; Lee, H; Shapiro, R; Sexton, J; Williams, C; Green, B
Digital Object Identifier (or PMID etc): Nil
Keywords: Nil
Abstract: The burn wound is a hypoxic injury. Adjunctive hyperbaric oxygen therapy may attack this problem directly, supplying borderline tissue with oxygen, thus preventing dermal ischemia, reducing edema, and maintaining microvascular integrity. Preservation of marginally viable tissue should result in a lessened need for surgery.
Conclusion: We report our experience with patients burned over 40-80% of their total body surface area, showing a significant reduction (P = < 0.041) in the need for surgery in patients receiving this additional therapy.
Article – 2 - Thermal Burns
Title: Air-activated chemical warming devices: effects of oxygen and pressure.
Authors: Raleigh, G; Rivard, R; Fabus, S
Digital Object Identifier (or PMID etc): Nil
Keywords: Nil
Abstract: Air-activated chemical warming devices use an exothermic chemical reaction of rapidly oxidizing iron to generate heat for therapeutic purposes. Placing these products in a hyperbaric oxygen environment greatly increases the supply of oxidant and thus increases the rate of reaction and maximum temperature. Testing for auto-ignition and maximum temperatures attained by ThermaCare Heat Wraps, Playtex Heat Therapy, and Heat Factory disposable warm packs under ambient conditions and under conditions similar to those encountered during hyperbaric oxygen treatments in monoplace and multiplace hyperbaric chambers (3 atm abs and > 95% oxygen) revealed a maximum temperature of 269 degrees F (132 degrees C) with no spontaneous ignition.
Conclusion: The risk of thermal burn injury to adjacent skin may be increased significantly if these devices are used under conditions of hyperbaric oxygen.
Article – 3 - Thermal Burns
Title: Burns treated with adjunctive hyperbaric oxygen therapy: A comparative study in humans.
Authors: Niu, AKC; Yang, C; Lee, HC; Chen, SH; Chang, LP
Digital Object Identifier (or PMID etc): Nil
Keywords: Nil
Abstract: Hyperbaric oxygen therapy (HBO) has become common adjunctive treatment for burn patients in the Naval General Hospital at Tsoying. In this study, 266 patients with total body surface area (TBSA) burns ranging from 7 to 90% (mean 34%) and ages ranging from 2 to 82 yr (mean 27 yr) were treated. When compared with 609 non-HBO-treated patients with TBSA burns ranging from 5 to 85% (mean 36%) and ages ranging from 7 mo. to 80 yr (mean 26 yr), the mortality rates were almost the same. In the HBO group there were 28 deaths (10.5%), and in the non-HBO group 79 deaths (13.0%)(P>0.05). The mortality HBO-treated, high risk patients with 35 to 75% TBSA, aged 15 to 45 yr, compared to non-HBO-treated cases, showed a statistically significant difference, 8 deaths in 117 cases in the HBO group (6.8%) vs. 25 deaths (14.8%) in 169 cases in the non-HBO group (P=0.028). In addition, in burns treated with HBO, fluid resuscitation could be achieved more rapidly, nasogastric feeding could be initiated in the second 24 h or earlier, and there was an acceleration of reepithelization. The average number of hospital days in high-risk patients treated with HBO was less than that in the non-HBO-treated group (47 d vs. 59 d), but this was not statistically significant (P>0.05).
Conclusion: Two cases treated with HBO who would not have been expected to survive are presented.
Article – 4 - Thermal Burns
Title: Hyperbaric oxygen and wound healing.
Authors: Bhutani S, Vishwanath G
Digital Object Identifier (or PMID etc): PMID: 23162231 PMCID: PMC3495382
Keywords: Air embolism; compartment syndrome; crush syndrome; decompression sickness; diabetes mellitus; diabetic foot; gas gangrene; hyperbaric; hyperbaric medicine; hyperbaric oxygen therapy; hyperbaric oxygenation; necrotising fasciitis; osteomyelitis; osteoradionecrosis; radiation injuries; radiation necrosis; reperfusion injury; soft tissue infections; surgical flaps; transcutaneous oximetry
Abstract: Hyperbaric oxygen therapy (HBOT) is the use of 100% oxygen at pressures greater than atmospheric pressure. Today several approved applications and indications exist for HBOT. HBOT has been successfully used as adjunctive therapy for wound healing. Non-healing wounds such as diabetic and vascular insufficiency ulcers have been one major area of study for hyperbaric physicians where use of HBOT as an adjunct has been approved for use by way of various studies and trials. HBOT is also indicated for infected wounds like clostridial myonecrosis, necrotising soft tissue infections, Fournier's gangrene, as also for traumatic wounds, crush injury, compartment syndrome, compromised skin grafts and flaps and thermal burns. Another major area of application of HBOT is radiation-induced wounds, specifically osteoradionecrosis of mandible, radiation cystitis and radiation proctitis.
Conclusion: With the increase in availability of chambers across the country, and with increasing number of studies proving the benefits of adjunctive use for various kinds of wounds and other indications, HBOT should be considered in these situations as an essential part of the overall management strategy for the treating surgeon.
Source URL:
http://www.ncbi.nlm.nih.gov/pubmed/23162231
Full text URL:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495382/
Article – 5 - Thermal Burns
Title: Thermal and Inhalation Injury: Effects of Fluid Administration and Hyperbaric Oxygen.
Authors: Yamaguchi, KT; Taira, MT; Stewart, RJ; Roshdieh, BB; Mason, SW; Dabbasi, NI; Naito, MS
Digital Object Identifier (or PMID etc): Nil
Keywords: thermal injury, smoke inhalation injury, hyperbaric oxygen, fluid administration
Abstract: Using a New Zealand white rabbit model system, the effects of HBO on various combinations of smoke inhalation and cutaneous bum injuries were studied. Results indicate that the use of HBO reduced the severity of pulmonary edema. This may occur by vasoconstriction of capillaries because elevated 02 pressure is thought to restrict the permeability of the endothelium to fluids. As anticipated, increasing the fluid resuscitation volume from 5 to 10% body weight contributed to an enhanced accumulation of lung water.
Conclusion: Inhalation injury alone resulted in a greater accumulation of extravascular lung water than inhalation injury plus a partial thickness bum wound. This may have been due possibly in part to a migration of neutrophils and macrophages to multiple injury sites with the combination injury.
Article – 6 - Thermal Burns
Title: Hyperbaric oxygen therapy for thermal burns.
Authors: Villanueva E, Bennett MH, Wasiak J, Lehm JP.
Digital Object Identifier (or PMID etc): PMID: 15266540
Keywords: Burns/therapy, Humans, Hyperbaric Oxygenation, Randomized Controlled Trials as Topic
Abstract: Hyperbaric oxygen therapy (HBOT) consists of intermittently administering 100% oxygen at pressures greater than 1 atmosphere in a pressure vessel. This technology has been used to treat a variety of disease states and has been described as helping patients who have sustained burns. The aim of this review was to assess the evidence for the benefit of hyperbaric oxygen treatment (HBOT) for the treatment of thermal burns. We searched the Cochrane Controlled Trials Register (The Cochrane Library, Issue 3, 2002), MEDLINE (Ovid 1966 to November Week 2, 2003), CINAHL (Ovid 1982 to December Week 2 2003), EMBASE (Ovid 1980 to September 2003), DORCTHIM (Database of Randomised Controlled Trials in Hyperbaric Medicine) from inception to 2003, and reference lists of articles. We included all randomised controlled trials that compared the effect of HBOT with no HBOT (no treatment or sham). Two authors using standardised forms extracted the data independently. Each trial was assessed for internal validity with differences resolved by discussion. Data was extracted and entered into RevMan 4.2.3.
Results: Four randomised controlled trials were identified, of which two satisfied the inclusion criteria. The trials were of poor methodological quality. As a result, it was difficult to have confidence in the individual results and it would not have been appropriate to attempt to pool the data. One trial reported no difference in length of stay, mortality, or number of surgeries between the control and HBO-treated groups once these variables were adjusted for the patient's condition. The second trial reported mean healing times that were shorter in patients exposed to HBOT (mean: 19.7 days versus 43.8 days).
Conclusion: This systematic review has not found sufficient evidence to support or refute the effectiveness of HBOT for the management of thermal burns. Evidence from the two randomised controlled trials is insufficient to provide clear guidelines for practice. Further research is needed to better define the role of HBOT in the treatment of thermal burns.
Source URL:
http://www.ncbi.nlm.nih.gov/pubmed/15266540
Full text URL:
http://www.sld.cu/galerias/pdf/sitios/rehabilitacion/hyperbaric_oxygen_therapy_for_thermal_burns.pdf
Article – 7 - Thermal Burns
Title: Hyperbaric oxygen therapy: solution for difficult to heal acute wounds? Systematic review.
Authors: Eskes AM1, Ubbink DT, Lubbers MJ, Lucas C, Vermeulen H.
Digital Object Identifier (or PMID etc): PMID: 21184071 PMCID: PMC3032900
Keywords:
Abstract: Hyperbaric oxygen therapy (HBOT) is used to treat various wound types. However, the possible beneficial and harmful effects of HBOT for acute wounds are unclear. We undertook a systematic review to evaluate the effectiveness of HBOT compared to other interventions on wound healing and adverse effects in patients with acute wounds. To detect all available randomized controlled trials (RCTs) we searched five relevant databases up to March 2010. Trial selection, quality assessment, data extraction, and data synthesis were conducted by two of the authors independently.
Results: We included five trials, totaling 360 patients. These trials, with some methodologic flaws, included different kinds of wound and focused on different outcome parameters, which prohibited meta-analysis. A French trial (n = 36 patients) reported that significantly more crush wounds healed with HBOT than with sham HBOT [relative risk (RR) 1.70, 95% confidence interval (CI) 1.11-2.61]. Moreover, there were significantly fewer additional surgical procedures required with HBOT (RR 1.60, 95% CI 1.03-2.50), and there was significantly less tissue necrosis (RR 1.70, 95% CI 1.11-2.61). In one of two American trials (n = 141) burn wounds healed significantly quicker with HBOT (P < 0.005) than with routine burn care. A British trial (n = 48) compared HBOT with usual care. HBOT resulted in a significantly higher percentage of healthy graft area in split skin grafts (RR 3.50, 95% CI 1.35-9.11). In a Chinese trial (n = 145) HBOT did not significantly improve flap survival in patients with limb skin defects.
Conclusion: HBOT, if readily available, appears effective for the management of acute, difficult to heal wounds.
Source URL:
http://www.ncbi.nlm.nih.gov/pubmed/21184071
Full text URL:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032900/#!po=80.7692
No more full texts available for this condition so adding 3 more abstracts without full texts
Article – 8- Thermal Burns
Title: Hyperbaric Oxygen As An Adjuvant Treatment For Burned Victims
Authors: Esteves, CH; Teixeira, SM; Branco, JR; Brito, TA
Digital Object Identifier (or PMID etc): Nil
Keywords: Nil
Abstract: Hyperbaric Oxygen Therapy (HBOT) a therapeutic modality pertaining to the Hyperbaric Medicine field, is indicated as an adjunctive treatment for several ischemic, inflammatory, infectious or traumatic origin diseases, with excellent results. The indication of the method for the treatment of burned patients is still controversial in spite of the expressive number of scientific publications presenting encouraging results concerning to the reduction of morbidity and mortality rates especially when initiated early, that is, during the acute phase of the trauma. We present a retrospective study of the clinical evolution of 28 patients who suffered 2nd e 3rd degree burns, with various etiologies and extensions, admitted at the HBOT services of the So Camilo Hospital, in Santana, So Paulo, Brazil, and the Casa de Portugal Hospital, in Rio Comprido, Rio de Janeiro, Brazil, from January 1995 to December 2000. The patients we submitted to a daily regimen of 120 minutes at 2,5 ATA (2,5 times over the absolute atmospheric pressure), in an American Sechrist 2500 or a Russian Khrunichev BKLS monoplace hyperbaric chambers, in association with the necessary and regular therapeutic measures for each case. Of the 28 patients, 20 (71,43percent) presented a fast haemodinamic and hydroelectrolitic stabilization, a better control of the infections and an accelerated granulation of the lesions with earlier hospital discharge. Six patients (21,43percent) gave up from the treatment and two (7,14 percent) died.
Conclusion: By our experience on the treatment of 28 patients with 2 and 3 degree burns from several etiological origins, combining HBOT with the conventional measures showed the necessity of a greater spread of the information about the importance of this therapeutic approach as an efficient way to control and reduce the extent of the thermal lesion and its complications.
Article – 9 - Thermal Burns
Title: Hyperbaric Oxygen Therapy 8 Hours After Liquid Helium Hand Burn
Authors: Brito, TA; Esteves, CH
Digital Object Identifier (or PMID etc): Nil
Keywords: Nil
Abstract: Second degree burns from direct contact with very cold gas is a rare clinical condition, which more often than not represents a serious lesion with remaining sequelae. Hyperbaric Oxygen Therapy (HBO2) is considered an efficient therapeutic method in the case of burns, especially during the acute phase. We present the effect of this therapeutic approach during the acute phase of the lesion. One patient was admitted at the emergency room with a second degree hand burn, 8 hours after an accident with liquid helium. After first aid treatment, he was refered to the Hyperbaric Service. He received 5 HBO2 treatments over 5 days, at 2.6 ATA, associated with surgical excision of the bullae but no antibiotics.
Results: The patient presented an excellent response to the treatment with fast recovery of normal sensation, disappearance of the paresthesiae of the fingers, recovery of normal temperature and aspect of the skin.
Conclusion: Second degree skin burns are potentially serious lesions and must be treated with the best approach possible. Lesions from the direct contact with low temperature gases are rare and the medical literature concerning to this is scarce. We believe that Hyperbaric Oxygen Therapy must strongly be considered during the acute phase.
Article – 10 - Thermal Burns
Title: Preliminary Report: A Prospective, Randomised, Controlled Trial Of Hyperbaric Oxygen Therapy In The Management Of Adult Thermal Burns.
Authors: Williamson, JA; Webb, RK; Leitch, IO; Pirone, C; Gorman, DF; Rowland, R; Jones, A
Digital Object Identifier (or PMID etc): Nil
Abstract: Small and large (J Hyperbaric Med 2:75,1987) studies suggest benefit to thermal burns from hyperbaric oxygen(HBO). Carbon monoxide toxicity remains a difficult variable to control in these patients. This is a report of the design and early implementation of an ethically approved, on-going study. METHODS: Following informed consent, each patient is stratified into one of 4 groups: 1.< 10% total body surface area(TBSA) burns, but involving hands, feet, face or genitals; 2.10-30% TBSA burns; 3. >30% TBSA burns; 4.Any TBSA burns with acute carbon monoxide(CO) poisoning. Each patient is then randomly allocated to a treatment or a control group. Patients "significantly" CO-poisoned (affected consciousness, psychoneurological signs, extrapolated venous COHb>25%) receive 2 x HBO treatments (each 2.8ATA x lh) in 24 hours, and are then stratified into groups 1,2 or 3. Group 4 patients with "non-significant" CO exposure are directly randomised into treatment or control groups. All treatment group patients receive 7 daily HBO exposures of 2.0ATA x l.5h. More than 24h-old burns, and obviously fatal burns are excluded. Mortality and morbidity (IV fluids, infection, analgesia, duration of IPPV, hospital stay, grafting, COHb%, burn depth & healing) are evaluated. Significance levels chosen are: alpha error p=0.05; beta error p=0.10. A second treatment group (normobaric oxygen, 1ATA) will be introduced.
Results: To date 11 (6 treatment, 5 control) patients are in the study. Mortality is zero. Numbers and matching are yet inadequate for results.
Conclusion: A mortality decrease of >= 20% (SPUMS J 18;121,1988) will take the study, working at this hospital, >= 5 years to attain significance.