September 25, 2018
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A New Step

New treatment incorporates hyperbaric chambers in wound care
Dr. Maureen Kuhrt, medical director of St. Mary’s Wound Care Clinic, stands near two new hyperbaric oxygen therapy chambers.

The use of Hyperbaric Oxygen Therapy in the field of medicine is surprisingly not as new as some may think. In fact, according to the article “Hyperbaric oxygen: its uses, mechanisms of action and outcomes” published in the QJM international journal of medicine, the first documented use of hyperbaric therapy was in 1662. More than 350 years later, the therapy still is in use, and St. Mary’s Wound Care Clinic has introduced the innovative treatment into its fold of services.

In late June, the clinic, located at 3801 Bellemeade Ave., welcomed two hyperbaric oxygen chambers to their facility. These chambers — two different sizes to accommodate patients — are a part of the only Hyperbaric Oxygen Therapy treatments currently in Evansville, says Courtney Will, program director at the wound care clinic.

“The facility is brand new, state of the art,” she adds.

Hyperbaric Oxygen Therapy involves a patient going into a chamber and breathing 100 percent oxygen at a pressurized level. The increased amount of oxygen they breathe provides many benefits, says Dr. Maureen Kuhrt, medical director at the wound care clinic.

“There are different ways that the hyperbaric oxygen can benefit patients, depending on the different indications,” she says. “For example, in wound healing, it’s able to get more oxygen and increase blood flow or blood vessels to the tissue.”

Early on when hyperbaric chambers were developed, they used compressed air rather than oxygen; it wouldn’t be until the 1930s that pressurized oxygen was first used to combat decompression sickness from diving. The U.S. military would further use the therapy after World War II, during experiments conducted on survivable pressures when diving. Hyperbaric oxygen would be commonly used in the late 1950s and early 1960s to treat radiotherapy effects, anaerobic infections, and carbon monoxide poisoning.

Today, Will says there are 14 wound indications approved through Medicare that qualify for hyperbaric treatment, while more are still being studied.

“It’s the last resort adjunct therapy that can either save a patient’s life or save their limb,” she says.

At St. Mary’s Wound Care Clinic, Kuhrt says there are at least four indicators they will start treating with their Hyperbaric Oxygen Therapy:

» Wagner Grade 3 diabetic foot ulcer: an ulcer associated with diabetes that has an abscess or underlying bone infection.
» Chronic refractory osteomyelitis: a bone infection that has not been amenable to other treatments such as surgery and antibiotics.
» Compromised flaps and skin grafts: when the patient’s own tissue used to cover surgical sites or non-healing wounds and starts to “die off.”
» Delayed Radiation injury: tissue injured during radiation treatment for a wide variety of cancers that can take months or years to surface.

“We’re very excited to have this here at St. Mary’s,” says Kuhrt. “Right now when we have patients who we think may benefit from Hyperbaric Oxygen Therapy, we have to send them elsewhere.”

“Those who qualify for Hyperbaric Oxygen Therapy are very ill,” adds Will, “so sending them out of town for treatment can become a major stressor for patients. Having the therapy available in Evansville takes away the need for patients to travel, while already requiring them to agree to a very large time
commitment for treatment.

“Once you’re here, it’s not so bad,” says Will. “Basically when they go in, it’s like relaxation for them. They lay in there, they can watch movies or TV, or sleep. They just kind of hang out, and we get to talk to them, get to know them.”

Patients who are treated with Hyperbaric Oxygen Therapy can expect two hours in the chamber, five days a week for at least 6 weeks or more, according to Kuhrt. There is roughly a 10-minute “descent” to higher atmospheric pressure, an hour and a half of treatment, and then a 10-minute “ascent” back to a normal atmospheric pressure.

Though someone can come to St. Mary’s Wound Care Clinic for hyperbaric treatment by any referral — physician, nurse practitioner, urgent care, and even self-referrals are accepted — a patient must be approved through consultation with Dr. Kuhrt before entering the chamber.

“There are a lot of variables to consider,” she notes. “Things that could be contraindications for going into a hyperbaric chamber.”

There can be rare side effects that occur from using the chamber, which is why it is important to see the patient and assess their health before using the treatment, says Kuhrt. For example, patients who are diabetic must have their glucose levels screened before treatment to prevent blood sugar from dropping during the session.

Keeping the safety of patients in mind during the build out also was a top priority for St. Mary’s. “We’ve taken every preventive measure known to man,” says Will.

The special features of the new hyperbaric oxygen treatment area range from special floors in the room to scrubs specific for patients in a hyperbaric chamber. Local fire departments and emergency medical services also are working with the clinic to be on call in case of any emergency.

“It’s something we’ve been working on for 2 and a half years straight,” says Will. “It’s been a big endeavor.”

For more information about St. Mary’s Wound Care Clinic, call 812- 485-7330 or visit stmarys.org/HBOT.

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