Oxygen therapy
venous stasis ulcers and devitalised
tissues in the lower limbs
District Madeyski Hyperbaric Chamber 2003
Oxygen therapy
We can say that oxygen therapy
has been the evolution of
Hyperbaric therapy used in the
last 30 years to treat
different pathologies related
to deficiencies of circulation
and infection.
District Madeyski Hyperbaric Chamber 2003
Principles on which hyperbaric oxygen
therapy is based
The Oxygen works by contact and because
dissolved in the blood ( a modest increase is
linked to the haemoglobin but a considerable
increase is dissolved in the plasma)
District Madeyski Hyperbaric Chamber 2003
Principles on which hyperbaric oxygen
therapy is based
Remember that in the Hyperbaric Chamber the
atmospheric pressure is increased while the
partial pressure of the oxygen remains invariable
District Madeyski Hyperbaric Chamber 2003
ULCERS AND
DEVITALISED TISSUES
IN THE LOWER LIMBS
1) Venous stasis ulcers
2) Arterial ulcers
3) Traumatic ulcers
4) Collagenopatic
ulcers
5) Diabetic ulcers
District Madeyski Hyperbaric Chamber 2003
THE THERAPIES
1)
2)
3)
4)
Medical therapy
Surgical therapy
Plastic surgery
Hyperbaric Chamber Therapy
District Madeyski Hyperbaric Chamber 2003
Hyperbaric Chamber
Advantages
increase oxygen
dissolved in the plasma
Disadvantages
-Not for all people
-Cardiac,vestibular or
cochlear tract, psychological
problems
-Limited availably
-Problems with travelling
distances
-No Availably of bed places
-Social and public costs
District Madeyski Hyperbaric Chamber 2003
The Madeyski District Hyperbaric Chamber
District Normobaric Chamber
so called since resembling the
Hyperbaric Chamber used by most
important Medical Centres.
District Madeyski Hyperbaric Chamber 2003
The Madeyski District Hyperbaric Chamber
District Normobaric Chamber
Advantages
increased oxygen in contact
with the lesion
Disadvantages
Minor increase by oxygen
dissolved in the plasma
Rilevant Advantage:
No local or general contraindication.
The Madeyski District Hyperbaric chamber
District Normobaric Chamber
Advantages:
1) Patient
satisfaction
2) Simple use and appreciation by
paramedic staff
3) The lack of general contraindications.
4) The lack of local contraindications
5) Its
reduced dimensions and easiness of transport
6) Its agreeable shape
7) Easily availability
8) The low cost of the device and its maintenance
9) Staff's quick training
10) Documented effectiveness
DIFFERENCES BETWEEN
THE HYPERBARIC CHAMBER AND
THE DISTRICT HYPERBARIC CHAMBER
General hyperbaric chamber
District hyperbaric chamber
The Oxygen concentration
reaches 22%
The Oxygen concentration
reaches 95%
Oxygen dissolved in the
plasma Vol 6 %
Oxygen dissolved in the
plasma Vol 2%
District Madeyski Hyperbaric Chamber 2003
Differences between the hyperbaric chamber
and the district hyperbaric chamber
Whilst in the hyperbaric chamber the treatment is through contact
and dissolved oxygen in the plasma, in the district normobaric
chamber the increase of dissolved oxygen in the plasma is lost
This missing effect is compensated by the increased oxygen
concentration in the district normobaric chamber
The concentration, in fact, reaches 95% or a set value which
therefore corresponds to 4 times the value found in the hyperbaric
chamber.
District Madeyski Hyperbaric Chamber 2003
Differences between the hyperbaric chamber
and the district hyperbaric chamber
But if an associated breathing in
an oxygen mask is performed , the
dissolved oxygen quota in the
plasma increases without reaching
the values due to hyperbarism.
2% Vol
against 6% Vol
District Madeyski Hyperbaric Chamber 2003
Times of application of District
hyperbaric chamber
Are different according to the
pathology and the local situation
Similarly the number of days in which
the therapy is applied is variable and
linked to the pathology and to others
contingent factors
District Madeyski Hyperbaric Chamber 2003
Times of application of District
hyperbaric chamber
The average therapy is applied
for the duration of one hour, twice a day
Similarly the number of days in which
the therapy is applied is variable and
linked to the pathology and to others
contingent factors
District Madeyski Hyperbaric Chamber 2003
Past case histories
141 patients treated with chamber
in an experimental period
During this period the chamber was not the
definitive one
District Madeyski Hyperbaric Chamber 2003
Present experience
196 patients so divided:
1) 150 venous stasis ulcers
2) 12 Arterial ulcers
3) 5 Traumatic ulcers
4) 3 Collagenopatic
ulcers
5) 22 Diabetic ulcers
6) 1 oncocarbide Ulcers
7) 13 patients with epidermic transplants
District Madeyski Hyperbaric Chamber 2003
Results
Considerations for a correct evaluation
Since we are dealing with a
chronic syndrome one can't
reach a definitive recovery
if the ethiology is not
corrected identified.
District Madeyski Hyperbaric chamber 2003
Results
Considerations for a correct evaluation
Sometimes,in subjects
affected by peculiar
pathology, a definitive
recovery can not be reached.
District Madeyski Hyperbaric cCamber 2003
Results
1) Decrease of the secretions
2) Improvement of
subjective sinthomatolgy
3) Improvement of objective sinthomatology
4) Cleaning
of the lesions
5) Reduction of the diameters
6) Evidence of the granulation tissues
the third day of application
since
7) A positive result of the transplants
expecially if Reverdin method is used
District Madeyski Hyperbaric Chamber 2003
The future …
1)Portable device of contained
cost for the house therapy
2) Nebulising for introduction
of drugs:
- vaso dilatators –
- healing
- for diabetic ulcers
3) Platelets concentrated
District Madeyski Hyperbaric Chamber 2003
Conclusions
The use of the Hyperbaric Chamber
with a partial increased oxygen
pressure is a very useful tool, at a
low-cost and without contraindications
for a large number of subjects with a
large amount of devitalised or not
very vital tissues ,due to local or
general causes in the inferior limbs
District Madeyski Hyperbaric Chamber 2003