Samil Aktas

Hyperbaric oxygen therapy in adriamycin extravasation: an experimental animal study.

&NA; Adriamycin extravasation is a serious problem that can lead to severe local necrosis and damage to underlying nerves, tendon, and muscle. There are some experimental studies in which conflicting results were reported about the beneficial effects of hyperbaric oxygen (HBO) in adriamycin‐induced skin lesions. In this study the effect of HBO on the healing of adriamycin‐induced wounds was investigated in the Wistar‐Albino rat model. Ninetyfive rats underwent injection of a 0.7‐ml adriamycin solution (2 mg per milliliter) subcutaneously on the right upper hind legs. The HBO group (n = 43) received HBO treatment (at 2.5 ATA for 80 minutes) twice a day for 28 days. The control group (n = 42) did not receive any therapy. Lesion size was measured for 4 weeks. There was no significant difference in lesion size between the groups on days 7 (p = 0.1364) and 14 (p = 0.1123), but the lesion size was significantly smaller in the HBO group than in the control group on days 21 (p = 0.0251) and 28 (p = 0.0001). Of 36 animals with lesions in the HBO group, complete wound healing occurred in 16 animals by day 40. However, there was no complete wound healing in any of the 36 animals with lesions in the control group. The beneficial effect of HBO in adriamycin‐induced skin lesions was observed in this experimental study. Aktaş Ş, Toklu AS, Olgaç V. Hyperbaric oxygen therapy in adriamycin extravasation: an experimental animal study. Ann Plast Surg 2000;45: 167‐171

Effects of hyperbaric oxygen therapy on distraction osteogenesis

Investigators in the present study explored the effects of hyperbaric oxygen (HBO) therapy on distraction osteogenesis in a rabbit limb-lengthening model. HBO treatment was provided to participants in a small animal pressure chamber once a day during the latent period of distraction osteogenesis at 2.5 absolute atmospheres of pressure. Bone mineral density measurements were obtained through torsional testing. The control group received no HBO treatment. Animals were killed 8 wk postoperatively for biomechanical testing. There was a statistically significant increase in bone mineral density in the HBO group compared with that in the non-HBO group, but no statistically significant differences were observed between biomechanical parameters of the 2 groups. The investigators suggest that these results must be further studied through histologic examination to determine the stepwise effects of HBO during and after collagen synthesis.

Does hyperbaric oxygen administration before or after irradiation decrease side effects of irradiation on implant sites

Background:One of the main limitations of implant-based breast reconstruction is the high rate of complications such as capsular contracture and poor aesthetic outcome, due to adjuvant radiotherapy. Hyperbaric oxygen treatment (HBOT) has been used to assist wound healing in the prevention and treatment of the side effects of irradiation. We aimed to investigate this effect of HBOT on the capsule reaction and skin, applied before and after irradiation, following the placement of an implant under the dorsal skin of the rat. Methods:Fifteen Wistar rats were randomly divided into 3 groups. A 18-mL smooth testicular implant was introduced into a subcutaneous pocket located on the dorsum of each rat. A single dose of 17-Gy irradiation was given to the implanted area of each rat at the third week. HBOT which lasted 3 weeks was administered to group I before irradiation, group II after irradiation. The control group did not receive HBOT.All of the rats were killed at the ninth week (6 weeks after irradiation). The dorsal skin with the capsule overlying the implant were excised for histopathological processing. The thickness of the capsule reaction of each group was evaluated statistically. Results:Our histopathological examination revealed changes due to radiation in the control group. Many of these findings were found to be more subtle in group I and nearly absent in the group II. There was not any statistical difference between the thickness of the capsule reactions of the control group and group I, or group I and group II, but the capsular thickness of the control group was statistically higher than group II. Conclusion:It can be predicted that the use of HBOT following irradiation is an effective tool to reduce the capsule reaction of the implanted area and the tissue damage seen in radiodermatitis.

Aural Barotrauma in Submarine Escape: Is Mastoid Pneumatization of Significance?

Objective: Submarine escape training is carried out by preselected, healthy young men under strictly controlled conditions regarding exposure to pressure and the rate of pressure change. This provides a unique opportunity to investigate the relations between middle ear characteristics and susceptibility to barotrauma while avoiding possible confounding parameters. We examined a possible association between mastoid pneumatization and middle ear barotrauma (MEB) in submarine escape trainees.

Hyperbaric oxygen therapy in the management of nonhealing wounds in patients with critical limb ischemia

Critical limb ischemia is characterized with intolerable pain at rest and nonhealing wounds and/or gangrene. The treatment of nonhealing wounds in patients with critical limb ischemia calls for an extraordinary effort. However, major amputation is required in a significant number of patients. Hyperbaric oxygen therapy is one of the adjunctive treatments used in nonhealing wounds. Hyperbaric oxygen therapy enhances collagen synthesis and maturation, fibroblast proliferation, epithelialization, increases leukocyte bacterial-killing capacity and induces angiogenesis. Hyperbaric oxygen therapy also exerts an antibacterial effect on selected microorganisms and reduces wound infection. Hyperbaric oxygen therapy is not a miraculous treatment modality. It is a good adjunctive therapy that increases the healing rate of wounds in selected patients. Hyperbaric oxygen therapy should be instituted together with conventional treatments. Antibiotherapy, strict metabolic control, daily wound care and debridement should n...

MRI Screening of Dysbaric Osteonecrosis in Hyperbaric-chamber inside Attendants

Inside attendants are medical staff who accompany patients during hyperbaric oxygen treatments. Dysbaric osteonecrosis (DON) is a well-known consequence of hyperbaric exposure. The aim of this study was to evaluate DON in inside attendants using magnetic resonance imaging (MRI). The bilateral shoulder, hip and knee joints of 12 inside attendants (four men, eight women; mean age 29 years; age range 22–36 years) were investigated. The mean ± SD duration of employment as an inside attendant was 3.8 ± 3.0 years (range 1–9 years) and the mean ± SD number of hyperbaric exposures was 198 ± 267 (median 96; range 30–950). None of the inside attendants had a history of decompression sickness. The MRIs of the attendants did not reveal bone lesions consistent with DON. This study failed to find an increased risk for DON in inside attendants. Additional multicentre epidemiological studies are warranted to investigate the occupational safety of inside attendants.

Hyperbaric oxygen therapy for chronic ulcers in systemic sclerosis – case series

Digital and leg ulcers are extremely painful, hard to heal manifestations of systemic sclerosis (SSc). Many treatments have been tried for these challenging complications, but use of hyperbaric oxygen therapy (HBOT) is very limited. HBOT has been used as an adjunctive therapy for treating chronic wounds, and nonhealing SSc wounds, which have a hypoxic nature, may also benefit from it.