Abstract
Dental extractions or surgical reconstructions performed in previously irradiated
tissue have high rates of complication and failure unless preoperative HBO2T is
performed (17-20).
4. AN EVIDENCE-BASED REVIEW OF THE EFFECTS OF HBO2T
IN WOUND HEALING
Hyperbaric oxygen therapy is considered the primary treatment for decompression
illness, arterial gas embolism, and carbon monoxide poisoning (21). The following
indications are accepted by the Undersea and Hyperbaric Medical Society (UHMS)
as adjunctive uses of HBO2T in various wound healing problems: acute thermal
burns, clostridial myonecrosis, other necrotizing soft tissue infections, compromised
skin grafts and flaps, crush injury, compartment syndrome, other acute traumatic
ischemias, osteoradionecrosis, soft tissue radionecrosis, refractory osteomyelitis,
and other wounds with demonstrated periwound hypoxia. The 2003 Hyperbaric
Oxygen Committee Report, available from the UHMS, provides an evidence-based
review of the literature for each indication (22). Several exhaustive evidence-based
reviews of world literature have been conducted by the following organizations or
entities: BlueCross=BlueShield (BCBS) Technology Assessment 1999, American
Diabetes Association Foot Council 1999, British Journal of Medicine 2000, 2001,
and the Medical Services Advisory Committee, Australia. Independently, they concluded that the data for acute ischemia, acute infection, diabetic ulcers, and radiation
supported the utility of HBO2T (23-26).