Use of hyperbaric oxygen therapy in severe earthquake injuries.

BACKGROUND: Earthquakes are natural disasters that can often cause severe injuries and traumatic situations. These injuries can include crush injuries, fractures, tissue damage, and blood circulation problems. Hyperbaric oxygen therapy (HBOT) has recently become a frequently used treatment modality for individuals suffering from severe injuries. HBOT is a form of treatment that involves administering pure oxygen to the patient under high pressure. This treatment aims to promote tissue healing by increasing cellular oxygenation. It is thought to have a positive effect on factors such as accelerating tissue healing, reducing inflammation, and controlling infection in severe post-earthquake injuries, particularly crush injuries. This study aimed to retrospectively evaluate the clinical effects, contributions to the healing process, and potential advantages of HBOT in 35 patients with severe injuries after the Kahramanmaras earthquake that occurred on 06.02.2023 and to contribute to the development of emergency intervention strategies. METHODS: This study was carried out after ethics committee approval. In the study, the data of patients with a MESS Score between 7-14 who were admitted as earthquake victims and treated in the HBOT Unit due to severe earthquake-related injuries were obtained from records and retrospectively analyzed. Demographic information, general distribution of patient data, mean values, number of HBOT sessions, and functional outcomes were recorded. RESULTS: The gender distribution of the 35 patients who received HBOT was 31.4% male and 68.6% female. 45.7% of patients were aged 18 years or younger, and 54.3% were aged 19 years or older. The most common injuries in the treated patients were observed in the lower extremities. After HBOT, sensory recovery (54.3%) and functional recovery (51.4%) were achieved in the majority of patients. The minor amputation rate was 20.0% and the major amputation rate was 11.4% after HBOT. CONCLUSION: This study evaluated the possible effects of HBOT on patients with severe earthquake injuries in Türkiye, and the results showed that HBOT may have a beneficial effect on critical factors such as sensory recovery, functional recovery, and amputation rates in this particular group of patients, and that this benefit may be more pronounced in those who started treatment early.

The Effects of Short- and Long-Term Exposure to Hyperbaric Oxygen on Nasal Mucociliary Clearance.

The aim of this study is to assess the effects of short- and long-term exposure to hyperbaric oxygen (HBO) on nasal mucociliary clearance (MCC). This study included 47 consecutive nondiabetic patients treated with hyperbaric oxygen therapy (HBOT). Participants were divided into 2 groups according to the taken number of HBOT sessions. Nineteen patients who received <11 HBOT sessions comprised short-term HBOT group, 28 patients who received more than 15 sessions comprised the long-term HBOT group. Mucociliary clearance was measured using a saccharin clearance test, which was performed 3 times on patients: prior to, at completion of, and 6 months after HBOT. The average number of HBOT sessions was 8 ±â€Š1.9 in short-term HBOT group and 20 ±â€Š4.8 in long-term group. Both short- and long-term exposure to HBO led to significant influence on MCC upon treatment completion (both P < 0.001). In addition, only long-term exposure to HBO caused significant elongation of MCC at long-term evaluation (6 months after HBOT). From these objective measurements, the authors can conclude that long-term exposure to HBO can cause irreversible damage to MCC compared with short-term exposure and HBOT appears to affect MCC in a dose-dependent manner. The clinical significance of this effect is of concern for patients undergoing HBOT for middle ear, sinonasal, or respiratory tract infections. Patients who undergo chronic HBOT should be monitored closely and informed about the possible negative effects.

Intralesional application of epidermal growth factor in limb-threatening ischemic diabetic foot ulcers.

OBJECTIVE: The intralesional injection of recombinant human epidermal growth factor (EGF-IL), a new therapy, has been claimed to prevent major amputations in advanced diabetic foot lesions. In this study, the efficacy of EGF-IL on advanced diabetic foot ulcers (DFU) was reviewed. METHODS: Intralesional 75 µg EGF application (Heberprot-P® 75, Heber Biotec, Havana, Cuba) to 12 diabetic foot lesions in 11 patients (8 males, 3 females; mean age: 62.2±10.6 years) was evaluated. Most of the patients had undergone revascularization and received hyperbaric oxygen therapy (HBOT) and negative pressure wound therapy (NPWT), along with standard care, but failed to heal. After amputation was offered as the final option, EGF-IL was applied to evaluate its effects. RESULTS: Two patients underwent amputation, while 10 lesions of the remaining 9 patients healed completely. CONCLUSION: Our results prove that intralesional application of EGF can prevent amputations in advanced diabetic foot cases with an ischemic component. However, evidence in the literature supporting its use remains lacking, and its high cost presents an additional problem. Thus, we believe that intralesional application of EGF should be an option for ischemic wounds only after vascular evaluation (and intervention when possible), HBOT, NPWT, and standard care have proven insufficient.