Osteomyelitis

Chronic refractive osteomyelitis is a recurring bone infection despite medical and surgical interventions of antibiotics, drainage, or removal of sequestrating bone.

Signs & symptoms :  History of past open fracture with non-healing. Chronic discharge from sinuses in the area. Deformity of the area with swelling and tenderness. Radiographic evidence of sequested bone (presence of dead bone).

Benefits of HBOT:

1. HBOT increases oxygen tension in infected tissue including bone, to normal or above normal levels. Can increase oxygen saturations of plasma around infected areas that have some remaining degree of diffusion, encouraging healing.
2. Provides adequate oxygen for fibroblasts-cells that make connected tissues/ and so promote healing and hypoxic tissue. Cells that remove dead bone (osteoclasts) need oxygen to function, and intermittent oxygen tensions of 30-40mmHg are needed to grow new blood vessels.
3. Hyperbaric oxygen is bacteriostatic (bacteria stopping). Neutrophils require PO2 30-40mmHg to do their work against bacteria.
4. Augments in effect of antibiotics such as Aminoglycosides, vancomycin, quinolones, and some sulfonamides.
5. Prevents polymorphonuclar (PMN) leukocytes (a kind of white cell) from adhering to damaged blood vessel linings, increasing the inflammation that often accompanies surgical treatment for refractory osteomyelitis.