Refractory osteomyelitis is chronic osteomyelitis that has persisted or recurred after appropriate interventions have been performed or where acute osteomyelitis has not responded to accepted management techniques. HBO2 adjunctive therapy, aggressive surgical debridement, parenteral antibiotics (or equivalent) and nutritional support improve patient outcomes. HBO2 should be initiated immediately following surgical debridement of infected bone.
RATIONALE: HBO2 promotes angiogenesis, increased leukocyte killing, aminoglycoside transport across bacterial cell walls, and osteoclast activity in removing necrotic bone. When used according to guidelines, HBO2 is clinically efficacious and cost effective.
Source: Hyperbaric Oxygen Therapy: A Committee Report. Undersea and Hyperbaric Medical Society. 1996 Revision.
Approved Indications
- Air or Gas Embolism
- Carbon Monoxide Poisoning and Smoke Inhalation
- Carbon Monoxide Poisoning Complicated by Cyanide Poisoning
- Clostridial Myonecrosis (Gas Gangrene)
- Crush Injury, Compartment Syndrome, Acute Traumatic Ischemias
- Decompression Sickness (the "Bends")
- Enhancement of Healing in Selected Problem Wounds
- Exceptional Blood Loss (Anemia)
- Necrotizing Soft Tissue Infections
- Osteomyelitis (Refractory)
- Radiation Tissue Damage (Osteoradionecrosis)
- Skin Grafts and Flaps (Compromised)
- Thermal Burns
Chico Hyperbaric Center
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