:: Case Report :::

History : 17 year old girl who is a known case of myelomeningocele and had undergone laminectomy when she was four month old.

Assessment : She presented to our unit with a non healing infected wound on the heel of her right foot. Since healing was not obtained with topical antibiotic treatment and wound care, she was referred to be evaluated for hyperbaric oxygen therapy (HBOT).On examination, she had excruciating pain estimated as 5 using scale of 0-10, 0 being no pain and 10 being worse pain ever experienced.
The wound classified as Wagner III and X-ray for Osteomyelitis was positive.

Outcomes : No additional dressings were needed after the completion of hyperbaric oxygen therapy. The surrounding skin was healthy, soft and granulation tissue in the wound bed has remarkably increased .Wound completely closed after 25 sessions.

History: A 68 year old female, smoker since 40 Years and had been diagnosed with Koch’s Disease 8 years back. She developed gangrene in fingers of right hand.

Assessment: She had pain in right hand with bluish black discolouration of the digits and rest pain since 10 – 15 days. She also complaint of associated rest pain in upper limb. As a part of investigation CT Angio showed occlusion of Right Interosseous artery.

Outcomes : Patient underwent 15 sessions of HBOT and showed significant improvement. Her pregangrenous fingers were saved.

History : Mrs K K, a 62 years old lady and a known case of Hypertension, coronary artery disease, Diabetes Mellitus and hyperthyroidism underwent hysterectomy for Ca endometrium in 1991. She also received radiotherapy (details not available).

Assessment : She presented to us with the symptoms of altered stool frequency and its consistency with pain.

Outcome : She took 40 HBOT sessions and showed much improvement.

History : A 70 year old female, is k/c/o Ca Tongue who was treated with radiotherapy. She developed recurrent oral ulcers and constant irritation of teeth.

Assessment : She had pain ranging 5 and had difficulty opening her mouth. She had swelling over her left jaw .Her XRAY showed Osteoradionecrosis of Mandible.

Outcomes : Patient underwent 25 sessions of HBOT with simultaneous removal of teeth, the teeth stumps healed promptly without complication and oral ulcers also showed signs of improvement. Patient could now have a proper taste and tolerate normal spicy food also.

History : A 52 year old male post surgical excision of cancer of the floor of the mouth followed by radiation therapy. Presented with osteoradionecrosis of the mandible and oral cutaneous fistula which failed to heal with conventional therapy. Complete resolution with a total of 91 Hyperbaric treatments and two flap procedures

Assessment : He presented to us with pain in jaw and mouth with no opening of mouth.

Outcomes : Patient underwent 50 sessions of HBOT and showed significant reduction in pain and improvement in overall well being.

History : A 36 year old female is a known case of SLE with vasculitis diagnosed in 2010.

Assessment : She presented to our department with pain in toes of both lower limb since 10-15 days associated with pricking sensation and blackening of left index finger and left great toe. Also, there was blackening of right great toe with B/L pedal edema. As a part of pain management she was being Inj.Alpostin, PCA morphine, Tramadol and Maxgalin. Her investigations revealed:
Arterial Color Doppler of (L) UL - Poor flow in digital arteries.
Arterial doppler of LL - Critical stenosis in Rt & Lt anterior tibial artery.
Diffuse plaquing in PTA & Peroneal artery (20 -40% stenosis)
Positive anti ds DNA test > 3000

Outcomes : Patient showed good recovery with increased healing, reduction in oedema and pain. She underwent 20 sessions of HBOT.

History : Mr.S.K is k/c/o diabetes since 15yrs, HTN and Stage V CKD. Recently he had injury in left big toe which was amputated.

Assessment : He presented to our department with gangrene in 2nd and 3rd left toe. His investigations showed calcification of the arteries with diffuse dense plaques in left peroneal artery, posterior tibial artery.

Outcomes : Patient showed good recovery with increased healing after 10 sessions of HBOT and good sugar management.

History : Mrs. HK was suffering from a non healing Ulcer for 2 years following Radiation for a suspected malignancy

Assessment : She presented to our department with non healing wound of right chest after she underwent mastectomy.

Outcomes : Patient showed good recovery with increased healing after 25 sessions of HBOT and good sugar management.

History : Mr BA, 51 yrs old businessman, diabetic and hypertensive had crush injury left forearm following a road traffic accident

Outcomes : He was given HBOT along with other medications and daily dressing. After 6 HBOT Tt wound showed enough circulation for a skin graft after 15 sessions he was discharged without further complication.

History : Mrs KK is k/c/o Osteomyelitis of left lower jaw. There is no history of Raynaud’s phenomenon and joint pain. She has undergone multiple sequential extractions from past one year.

Assessment : She presented to us with swelling of left side of face and restricted mouth opening of 3mm. She also gave history of tongue and lingual paraesthesia. OPG revealed unhealed multiple tooth extraction sites of left lower posterior jaw.

Outcomes : Patient was advised for HBOT and with 10 sessions there was significant improvement seen with reduction of pain and better mouth opening.