A Case of Hyperbaric Oxygen as Adjunct to Fascio-tomies in Compartment Syndrome, Ischemia-Re-perfusion Injury, and Delayed Secondary Infection

Authors

  • Dawnielle C. Endly Midwestern University College of Osteopathic Medicine, Glendale, AZ, USA
  • Joan V. Eggert Intermountain Dixie Regional Health Center, St. George, UT, USA

DOI:

https://doi.org/10.5195/ijms.2013.211

Keywords:

Reperfusion Injury, Hyperbaric Oxygenation, Surgical Decompression

Abstract

Background: Fasciotomies are a therapeutic treatment for compartment syndrome, but they also allow reperfusion to tissues that have been hypoxic. We report a case study of a 52-year-old male with an ischemic leg. Despite prophylactic fasciotomies, ischemia-reperfusion injury resulted in delayed myonecrosis and progressive necrotizing fasciitis.

Results: After two hyperbaric oxygen treatments, edema was markedly reduced and all visible wound tissues were well perfused without evidence of ascending infection, allowing the patient more time for further evaluation. The patient did opt for an above the knee amputation in a non-emergent setting and now successfully utilizes a prosthesis for ambulation.

Conclusion: Ischemia-reperfusion injury may result in delayed tissue loss in spite of appropriate fascioto­mies. Hyperbaric oxygen may be a useful adjunct therapy even when initiated days after the initial injury.

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Author Biography

Dawnielle C. Endly, Midwestern University College of Osteopathic Medicine, Glendale, AZ, USA

Dawnielle Endly is a 4th year medical student at Midwestern University Co­llege of Osteopathic Medi­cine, Glendale, AZ, USA

References

1. Wattel F, Mathieu D, Neviére R, Bocquillon N. Acute peripheral ischaemia and compartment syndromes: a role for hyperbaric oxygenation. Anaesthesia 1998;53Suppl2:63.
2. Masquelet AC. Acute compartment syndrome of the leg: pressure measurement and fasciotomy. Orthop Traumatol Surg Res 2010;96(8):913- 17.
3. Greensmith JE. Hyperbaric oxygen therapy in extremity trauma. J Am Acad Orthop Surg 2004;12(6):376-84.
4. Zamboni WA, Wong HP, Stephenson LL. Effect of hyperbaric oxygen on neutrophil concentration and pulmonary sequestration in reperfusion injury. Arch Surg 1996;131(7):756-60.
5. Zamboni WA, Browder LK, Martinez J. Hyperbaric oxygen and wound healing. Clin Plastic Surg 2003;30(1):67-75.
6. Thom SR. Hyperbaric oxygen: its mechanisms and efficacy. Plast Reconstr Surg 2011;127Suppl1:131S.

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Published

2013-08-31

How to Cite

Endly, D. C., & Eggert, J. V. (2013). A Case of Hyperbaric Oxygen as Adjunct to Fascio-tomies in Compartment Syndrome, Ischemia-Re-perfusion Injury, and Delayed Secondary Infection. International Journal of Medical Students, 1(2), 91–93. https://doi.org/10.5195/ijms.2013.211

Issue

Vol. 1 No. 2 (2013)

Section

Case Report

Categories

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