Crush Injuries and Suturing of Severed Limbs

As in the previous condition, HBO therapy would be an adjunctive treatment when loss of function, limb, or life is threatened. Acute traumatic ischemia is the result of injury by external force or violence compromising circulation to an extremity. The extremity is then at risk for necrosis or amputation. Secondary complications are frequently seen: infection, non-healing wounds, and non-united fractures. The goal of HBO therapy is to enhance oxygen at the tissue level to support viability. When tissue oxygen tensions fall below 30 mmHg, the body's ability to respond to infection and wound repair is compromised. Using HBO at 2 - 2.4 atm, the tissue oxygen tension is raised to such a level that the body's responses can become functional again. The benefits of HBO for this indication are enhanced tissue oxygenation, edema reduction, and increased oxygen delivery per unit of blood flow, thereby reducing the complication rates for infection, non-union, and amputation.

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