Hyperbaric oxygen therapy is a well-known, established treatment for decompression sickness, a hazard of scuba diving. What is however not commonly known is that hyperbaric oxygen therapy is also a recognised and effective medical treatment for a range of other conditions including diabetes-related wounds, failing skin grafts, radiation injury, limb crush injuries and thermal burns, to mention but a few.
“In fact, diving accidents make up a small minority of the cases treated at Hyperbaric and Wound Care Medical Centre located at Netcare St Augustine's Hospital in Durban,” says Dr Michael Marshall, a centre director and medical practitioner who specialises in hyperbaric oxygen therapy treatment.
Pic: The Hyperbaric and Wound Care Medical Centre at Netcare St Augustine’s Hospital is the only hospital-based medical facility of its kind in KwaZulu-Natal and has the only multi-place hyperbaric chamber, which can provide therapy for up to 10 patients at a time.
“Although we are one are the busiest facilities in the country for treating decompression sickness, or ‘the bends’ as it is more commonly known, handling between 10 to 20 these kinds of cases a year, these constitute but a fraction of the conditions that we actually treat,” observes Dr Marshall.
The Hyperbaric and Wound Care Medical Centre was opened in 2000. It not only remains the only hospital-based medical facility of its kind in KwaZulu-Natal but also has the only multi-place chamber, which can provide therapy for up to 10 patients at a time.
“The chamber, which looks a lot like a mini-submarine and is certified to a pressure equivalent to a depth of 60m of seawater, has successfully treated hundreds of patients with a variety of conditions over the years. Therapy is provided in accordance with the strict treatment protocols of the South African Undersea and Hyperbaric Medicine Association [SAUHMA],” adds Dr Marshall.
“We have on occasion assisted with simultaneously treating several divers for the bends after they have been involved in scuba diving incidents,” reflects Dr Marshall on the 17-year history of the Durban hyperbaric oxygen chamber. “The multi-place chamber has proved ideal for such cases.“
“More typically, however, our patients have required supportive therapy for, among others, post-radiation therapy tissue injury; non-healing foot ulcers, which commonly occur in diabetics; chronic bone infections; limb crush injuries; thermal burns in which skin is burnt by an external heat source; threatened grafts and flaps; and for certain cases of sudden deafness.”
The centre recently, for instance, provided oxygen therapy to a 57-year-old type II diabetes sufferer from Durban, who was undergoing treatment for a diabetes associated foot ulcer by his medical specialist. The man was referred to the facility for supportive therapy for the ulcer, which was proving highly resistant to other types of treatment, notes Dr Marshall.
“After a few sessions in the hyperbaric oxygen chamber, the blood flow to the wound was improved and it soon began healing, averting the threat of gangrene developing, which could have resulted in the patient’s toes, or even his foot having to be amputated.
“In cases where wounds are failing to heal due to a poor oxygen supply, hyperbaric oxygen therapy can make a substantial difference to wound healing and can even make the difference between a limb being lost or preserved,” he asserts.
Dr Marshall explains that hyperbaric oxygen therapy dissolves oxygen directly into the blood plasma, thereby enabling higher levels of oxygen to reach areas where circulation is diminished or obstructed as a consequence of disease or injury.
This non-invasive and painless treatment can reduce swelling in acute injuries, stimulate the growth of new blood vessels in tissues that have an inadequate blood circulation, and boost the immune system in fighting certain types of infections.
“Hyperbaric oxygen therapy is most often used alongside other treatments to promote healing, and while it is by no means a cure for all diseases, it has numerous recognised medical applications today,” notes Dr Marshall.
Oxygen therapy is prescribed by a physician and performed under close medical supervision. Although it may carry minor risks for some patients, including the possibility of causing minor middle ear injury as a result of the increased air pressure, it is considered very safe. The treatment has some contraindications, so patients with a history of chest surgery or injury may, for example, be precluded from receiving the treatment.
Dr Craig Springate, who is a medical director of the Hyperbaric and Wound Care Medical Centre with Dr Marshall, points out that the centre at the Netcare St Augustine’s Hospital is situated directly underneath the emergency department, and in close proximity to the operating theatres and intensive care unit, which makes the centre easily accessible to patients.
“The chamber itself has been purpose developed to facilitate easy treatment of all types of patients including mobility-impaired, stretcher-bound and bariatric patients. Traditionally chambers were made with circular hatch-style doors, which made access difficult for those who had problems with their mobility. Our purpose-designed chamber door allows ambulant patients to walk rather than have to climb into the chamber, and it is also possible to wheel a stretcher directly into it,” explains Dr Springate.
Affirming the healing potential of oxygen therapy for appropriate cases, Dr Springate relates another recent case in which a 26-year-old man from Durban was brought in for supportive treatment for severe burns to his face and chest after an accident with an acetylene torch. With the correct wound care in hospital and a few hyperbaric treatments his wounds healed rapidly.
In addition to medical directors Dr Marshall and Dr Springate, both of whom have had extensive training and are highly experienced in hyperbaric oxygen medicine, the centre has six staff members who specialise in the treatment and assist in operating the chamber.
Dr Springate says that there are some hyperbaric chambers in the commercial diving sector in KwaZulu-Natal, but the one at Netcare St Augustine’s Hospital is the only hospital-based unit in the province. Other hyperbaric oxygen facilities within the Netcare Group are situated at Netcare Milpark Hospital in Johannesburg and Netcare Pretoria East Hospital in Pretoria, while Medicross Tokai in Cape Town also operates a single-patient chamber.
“The Hyperbaric and Wound Care Centre at the hospital has a long and distinguished track record,” says Netcare St Augustine’s Hospital general manager, Heinrich Venter. “It has established itself as a critical treatment facility at our hospital and as the key private service provider in KwaZulu-Natal. We are gratified to be able to offer this important treatment option and support therapy to our patients,” he concludes.
Issued by: MNA on behalf of Netcare St Augustine’s Hospital
Contact: Martina Nicholson, Graeme Swinney, and Meggan Saville
Telephone: (011) 469 3016
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