Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...

who were pregnant. There were almost twice as many males as females recruited (21
versus 11), and the mean age of the two groups was about 25 years.
The study was a randomised controlled trial conducted in the United States.
Randomisation was adequately described, and the study was double masked. There were
no losses to follow-up.
All subjects were treated using a two-program protocol involving splinting of the injured
appendage, pain relief medication, active range of motion, balance, and isometric
exercises, and ice. Those assigned to the intervention group were exposed to HBO in a
mono-multiplace hybrid (single person breathing with mask) chamber at 2 ATA for three
treatments over seven days. The first session was for 90 minutes; the last two sessions
were 60 minutes each. Placebo exposure was similar in the comparison group, except
that air was given at 1.1 ATA.
The following end points were examined: ankle pain using a visual analogue scale, ankle
oedema using a volumeter, active and passive ankle range of motion, ankle function
using a seven-point scoring system, and time to full recovery (defined as attaining a score
of seven on the ankle function scale). During the course of therapy to full recovery, no
statistically significant differences were apparent between the two groups on all
outcomes.
Summary
This study provided no evidence to support the use of HBOT for acute ankle sprains.
Crush injuries
Bouachour et al86 enrolled patients with Gustillo87 Type II or III acute injury of the lower
limb. The patients had surgical management within six hours of injury and they had no
history of peripheral occlusive arterial disease. They excluded patients enrolled in another
trial, those who were suspected of being pregnant, or those with neurologic, pulmonary,
or otorhinolaryngologic disease.
The authors recruited 36 patients into this double-masked randomised controlled trial.
All patients underwent debridement, wound irrigation, primary closure, arterial and
venous repairs, and fasciotomies. Cloxacillin and ornidazole were given as first line
antibiotics with a modification of therapy following the results of microbial sensitivity
results. Tedelparin was also given as an antithrombotic agent. Half of the group was
exposed to HBO in a multiplace chamber at 2.5 ATA twice a day for six days. The
comparison group was exposed to air in the same chamber at a pressure of 1.1 ATA.
The authors examined four major outcomes: wound healing without tissue necrosis
requiring surgical excision, new major surgical procedures after entry in the trial, time of
healing, and length of hospital stay (Table 46).
50 Hyperbaric oxygen therapy