Crush injuries occur when body tissues are severely traumatized such as in motor vehicle accidents, falls, and gunshot wounds. These injuries frequently occur in the extremities. When crush injuries are severe, the rate of complications such as infection, non-healing of fractures and amputations range up to 50%. Release of pressure that occluded circulation continues the sequence of edema, anoxia and tissue destruction. Post traumatic edema further reduces oxygen supply to tissues by increasing the oxygen distance must travel to diffuse to and from cells, and by directly impairing microcirculation. The resulting decrease in tissue oxygen tension impairs wound healing by interfering with the ability of neutrophils to fight bacteria, new cell growth, and collagen disposition. White blood cells need oxygen to kill microbes. New cell and vessel growth cannot take place without oxygen-dependent collagen, so that a wound does not occur.
Benefits of HBOT :When used as an adjunct to orthopaedic surgery and antibiotics, hyperbaric oxygen (HBO2) therapy shows promise as a way to decrease complications from severe crush injuries. HBO2 increases oxygen delivery to the injured tissues, reduces swelling and provides an improved environment for healing and fighting infection. HBO reduces reperfusion injury by preventing lipid peroxidation, neutrophil adherence, and free radical build up. Increased oxygen tensions in hypoxic tissues allow healing and help prevent spread of infection and damage to adjacent, non-involved tissue, decreasing complication rates and cost of management.