Hyperbaric oxygen therapy of soft tissue necrosis due to centipede bite in a patient with diabetes.

OBJECTIVE: The purpose of this study is to demonstrate that hyperbaric oxygen therapy (HBOT) is an option for the management of rapidly progressive tissue necrosis after centipede bites in patients with diabetes. METHOD: In this case report, we introduce a patient with diabetes with soft tissue necrosis and secondary infection due to a centipede bite, who was treated with a multidisciplinary approach including HBOT. RESULTS: In this case study, HBOT, applied in the treatment of rapidly developing cellulitis after a centipede bite in a patient with diabetes, accelerated wound healing. Deep soft tissue infection stopped progression to necrotising fasciitis and prevented possible amputation, and facilitated the patient's return to social life in a short time. CONCLUSION: HBOT can be used in combination with other local and systemic, due to its anti-venom effect and treatment of extremity-threatening infection.

Selective Nerve Block Combined With Tumescent Anesthesia.

PURPOSE: To evaluate the effect of selective nerve blocks before tumescent anesthesia on the pain and anxiety levels of patients. METHODS: A prospective study was performed with 80 patients. Forty consecutive patients received tumescent anesthesia, and 40 consecutive patients received selective nerve blocks followed by tumescent anesthesia. Patients filled out a questionnaire regarding their preoperative, intraoperative, and postoperative pain and anxiety levels. The results of the questionnaire were evaluated with an independent samples t test. RESULTS: The 2 study groups showed similar distribution in age, sex, and diagnosis. No complications related to tumescent anesthesia or nerve blocks were observed. The group that received tumescent anesthesia with selective nerve blocks reported lower pain scores in anesthesia injections than the group that received tumescent anesthesia alone. The intraoperative and postoperative pain and anxiety levels between the groups were not different. CONCLUSION: Tumescent anesthesia combined with selective nerve blocks in hand surgery decreased the pain associated with injections and increased patient satisfaction. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic I.