Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...
Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...
Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...
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Osteomyelitis<br />
The study by Esterhai et al 58 was a comparative study published in 1987. The study was<br />
conducted in the United States and examined 28 consecutive patients (19 males), aged 15<br />
to 74 years (mean = 40), with chronic refractory osteomyelitis uncomplicated by<br />
persistent fracture non-union, septic arthritis, total joint arthroplasty or major systemic<br />
disease.<br />
The comparison group underwent debridement, and antibiotics were given based on the<br />
results of microbial sensitivity. Fourteen subjects were exposed to HBO at 2 ATA for<br />
2 hours daily, six days a week.<br />
Exposure to HBOT did not produce a statistically significant improvement over the<br />
comparison therapy in length of hospitalisation, clinical outcome, or recurrence<br />
(Table 30).<br />
Table 30 Outcomes in intervention and comparison groups with osteomyelitis (Esterhai et al). 58 *<br />
Outcome Intervention Group<br />
(n=14)<br />
Mean length of hospitalisation (days)<br />
54<br />
(41-143) †<br />
Comparison Group<br />
(n=14)<br />
47<br />
(10-66) †<br />
Treatment success (n) 11 13 0.2801<br />
Recurrences ‡ (n) 2 1 0.5412<br />
* Abbreviations: n = sample size.<br />
† Figures in parentheses are ranges.<br />
‡ Follow-up ranged from 11 to 77 months (mean = 41.1).<br />
Summary<br />
The regime of HBOT reported in this study does not seem to be beneficial to patients<br />
diagnosed with osteomyelitis in terms of their length of hospital stay, the treatment<br />
successes, and the risk of recurrence following therapy. However we should note that<br />
this regime differs in several respects to HBOT regimes used for other indications,<br />
calling into question the extent to which findings may be generalisable.<br />
Osteoradionecrosis<br />
Two aspects of the control of this condition are examined: prevention and treatment.<br />
Prevention<br />
Marx et al59 published a study in 1985 describing the results of a randomised controlled<br />
trial conducted in the United States. The trial involved 74 patients (ages and genders not<br />
specified) who had an indication for removal of one or more teeth in a segment of the<br />
mandible which had received a documented absorbed dose of 6,000 rads or greater, and<br />
who agreed to maintain follow-up visits for a minimum of six months. Excluded were<br />
patients who received irradiation less than six months or more than 15 years prior to<br />
enrolment, had known contraindications to penicillin or exposure to 100% oxygen at 2.4<br />
ATA, showed evidence of persistent tumour or new primary malignant disease, received<br />
chemotherapy within six months of enrolment, including steroid drugs, or had<br />
concomitant systemic disease which could be expected to affect wound healing.<br />
<strong>Hyperbaric</strong> oxygen therapy 39<br />
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