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Hyperbaric Oxygen in Trauma and Surgical Emergencies
  1. Campbell MacFarlane, Hons. BA, BSc (Hons), MBChB, MMed (Surg), PhD, FRCS (Ed), FRCS (Eng), FACS, ACEM (Hon.), FFAEM, MRACMA, DMCC1,
  2. Frans J Cronjé, BSc (Hons) Aerosp Med, MBChB2 and
  3. Carol-Ann Benn, MBBCh, FCS(SA), DIP.PEC(SA), Consultant Surgeon3
  1. 1Gauteng Health Department Emergency Medical Services – Johannesburg Honorary Consultant, Johannesburg Hospital Trauma Unit - University of the Witwatersrand macfarlaneca{at}ems.gpj.co.2a
  2. 2Hyperbaric Unit, Eugene Marais Hospital, Pretoria
  3. 3Baragwanath Hospital, Johannesburg, University of the Witwatersrand

Abstract

Hyperbaric oxygen therapy (HBO), that is the administration of 100% oxygen delivered under pressure, has a beneficial effect in several surgical conditions. Its use has been assessed and audited and its pharmacological effects demonstrated. It is appropriate for use in several acute surgical conditions as evidence-based therapy. These are:

  • Gas Gangrene

  • Crush Injuries, Compartment Syndromes & Acute Traumatic Ischaemias

  • Enhancement of Healing in Selected Problem Wounds

  • Exceptional Bloodloss Anaemia

  • Necrotising Soft Tissue Infections

  • Compromised Skin Grafts & Flaps

  • Thermal Burns

HBO therapy suffers from previous inappropriate use, lack of knowledge, and scarce hyperbaric facilities. Hyperbaric therapy, when properly supervised by a physician trained in its use, working closely with a surgeon, and ethically used for appropriate indications, can be a useful adjunct to surgical practice. Military surgeons may be in a situation in which they can utilize HBO in acute surgical conditions and trauma. They are urged to identify HBO facilities, both fixed and portable, and to establish communication with hyperbaric therapy colleagues.

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