Role of Hyperbaric Medicine for Osteoradionecrosis and Post Irradiation Wounds: an Institutional Experience
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ORIGINAL ARTICLE
Role of Hyperbaric Medicine for Osteoradionecrosis and Post Irradiation Wounds: an Institutional Experience Pradeoth Mukundan Korambayil 1 & Prashanth Varkey Ambookan 1 & Sreekumar Pillai 1 & Rameela Ravindran Karangath 2 & Deepak George 3 Received: 28 March 2019 / Accepted: 8 June 2020 # Indian Association of Surgical Oncology 2020
Abstract To study the effectiveness of hyperbaric medicine in osteoradionecrosis and irradiation induced wounds. To evolve a protocol for management with combined surgical modality for irradiation induced injury. This study was carried out in the Plastic Surgery Department, from November 2011 to December 2018. A total of 30 patients with post irradiation patients subjected to hyperbaric oxygen therapy during the management were enrolled in the study. The results regarding the changes in wound and complications were noted. Out of 30 patients, 20 patients were with radiation injury involving the oral cavity, one patient with left lower limb, one with breast, 3 with radiation injury of cheek, 3 of mandible, one with radiation cystitis and one involving the tooth socket. One patient experienced reversible myopia as a complication of hyperbaric therapy. No other complications were noted. Hyperbaric therapy is a useful adjunct for surgery in management of osteoradionecrosis and post irradiation wound and proves therapeutic in some post irradiated wound where we cannot offer surgical correction. Keywords Hyperbaric medicine . Osteoradionecrosis . Post irradiation wounds
Introduction Radiation-related complications after malignancy are more common due to the cellular hypoxia, progressive endarteritis of the minor blood vessels and damage to the normal healing process in the irradiated tissue. Discoloration, ulceration and necrosis are common in this irradiated tissue. With this presentation, unfortunately the treatment failure is high, as there is a compromised blood supply and inherent inability of the radiated tissue to heal. Hyperbaric oxygen therapy with the mechanism of oxygen-induced angiogenesis modifies the
tissue damages incurred by radiation injury and promotes healing in the irradiated tissue [1]. Craighead et al. [2] conclude that hyperbaric oxygen therapy is likely effective and should be applied in refractory disorders. HBO2 may provide symptom resolution in certain complications of radiation and may reduce complications when combined with surgery removing tissues and organs affected by necrosis.
Materials and Methods * Pradeoth Mukundan Korambayil [email protected] 1
Jubilee Institute of Surgery for Hand, Aesthetic & Microsurgery, Department of Plastic Surgery & Burns, Jubilee Mission Medical College and Research Institute, Bishop Alapatt Road, Thrissur, Kerala, India
2
Department of Computer, St. Thomas College (Autonomous), Bishop Alapatt Road, Thrissur, Kerala, India
3
Department of Radiotherapy, Government Medical College Thrissur, Bishop Alapatt Road, Thrissur, Kerala, India
The study was conducted in the Department of Plastic Surgery and burns.
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