A former skydiver undergoing a medical treatment first developed for scuba divers, has described how hyperbaric oxygen therapy (HBOT) was his ‘last hope’ when a skin graft on his nose was threatened. Breathing pure oxygen while contained in a metal ‘bubble’ with up to three times the normal atmospheric pressure at sea level offers healing properties for a surprising range of conditions.
Originally designed to treat scuba divers’ decompression sickness, commonly known as ‘the bends’, today HBOT is recognised as a beneficial supportive therapy for 14 medical conditions. From sudden deafness to diabetic foot ulcers and crush injuries, to threatened skin grafts and flaps, radiation and thermal burns, the applications of hyperbaric oxygen therapy have grown significantly in the 60 years since the technology was first introduced in South Africa.
| Pic: Hyperbaric oxygen therapy [HBOT] is beneficial for wound healing among a surprising range of indications. Pictured inside the special pressure room at Netcare St Augustine’s Hospital are (left to right) Ronel Lowe, person centred care officer; Cornelius Herbst, representing a patient, Nicola Hariparsad, hospital marketing manager, Zaid Mem Buccus, ward administrator, and Chad Katz, manager of the hyperbaric unit at Netcare St Augustine’s Hospital, illustrating how relatively spacious the HBOT chamber is. |
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“The therapeutic effects of HBOT can only be achieved in properly certified medical facilities, of which only a handful are accredited by the Southern African Undersea and Hyperbaric Medical Association [SAUHMA] in the country,” says Dr Craig Springate, medical director of the Hyperbaric and Wound Care Medical Centre at Netcare St Augustine’s Hospital.
Equivalent to 14m under the sea
HBOT has various mechanisms of action to promote healing. By providing an oxygen rich environment, it improves the functioning of the immune system and reduces swelling. It is also known to help optimise the effectiveness of antibiotics.
The HBOT facility at Netcare St Augustine’s Hospital – a turquoise metal ‘bubble’ walk-in chamber that can accommodate several patients at once – resembles something out of a classic spy film. While cellphones and electronics are not allowed inside the special high-pressure room, patients can read books or magazines during the session.
Former skydiver Desmond Holdcroft was referred to Dr Springate for HBOT after several operations to remove a melanoma and reconstruct his nose. A skin flap from Mr Holdcroft’s forehead was stitched to his nose to supply blood to the skin graft until it healed. In the tight angle needed to reach the nose, this ‘twist’ in the skin flap unfortunately throttled the blood flow and oxygen supply to the tip of Mr Holdcroft’s nose, threatening his skin graft.
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“My treating doctor suggested hyperbaric oxygen therapy as my last hope after the second skin flap procedure. After my next surgery, I was taken straight to the HBOT centre for therapy. Dr Springate and the team explained to me that once I was inside the room, it is gradually pressurised until it is equivalent to being 14 metres below sea level.”
Mr Holdcroft had two sessions of HBOT each day for a week. “We took photos before and after each session. Before, the skin was almost black and after I came out it was pink. After each session you could see the difference, and it got a little better each day until it healed over, and I no longer required the therapy.”
Every treatment is supervised by a qualified attendant and safely controlled by a trained operator, overseen by an onsite hyperbaric physician. During HBOT, it is common to feel some pressure in your ears, although this is relieved with equalising as with air travel. Patients wear a clear hood filled with pure oxygen, which helps to stimulate healing in the skin, tissues and bone. The treatment increases the levels of oxygen in the blood by up to five times, restoring ‘life’ to compromised tissues starved of oxygen.
Mr Holdcroft adds that he was so impressed with the effects of HBOT that he was surprised other plastic and reconstructive surgeons he spoke to were unaware of its application for skin grafts. “Fortunately, my doctor was aware of it and the skin graft on my nose has taken well,” he says.
Significant differences between HBOT and air pressure therapy
Dr Springate warns that the public should be aware of a recent mushrooming of lower pressure air therapy services that are not up to the rigorous medical standards of recognised hyperbaric oxygen therapy (HBOT) units and cannot offer the same therapeutic effects. “It is important to be aware that SAUHMA accredited HBOT units are quite distinct from air pressure therapy, sometimes referred to as ‘mHBOT’, which is a non-medical service that often trades on unsupportable claims.
“Properly certified HBOT, on the other hand, is increasingly recognised by medical aids when patients are referred for treatment for the specified list of indications, with the appropriate motivation, although we also treat many private patients,” Dr Springate adds.
The treatment is guided by strict protocols and is very safe for appropriate patients although it has certain contraindications. For example, it is not suitable for patients with a history of chest surgery or injury, or for people who take certain medications.
In addition to the Hyperbaric and Wound Care Medical Centre at Netcare St Augustine’s Hospital in KwaZulu-Natal, HBOT is also available at specialised units at Netcare Milpark Hospital in Gauteng and at Netcare Medicross Tokai in the Western Cape.
Warning to others
“As a skydiver, I spent so much time in the sun on airfields and in those days, we had no idea how damaging UV rays are. I am nearly 70 years old, and I am now seeing the consequences of sun damage and the dangers of skin cancer. I would like to warn everyone to really look after your skin and teach your children the importance of sun protection. Avoid spending time in the sun and always wear a high sun protection factor sunscreen to help prevent skin cancer,” Mr Holdcroft says.
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Notes to editor
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