1. venous stasis ulcers and devitalised tissues in the lower limbs
Oxygen therapy
venous stasis ulcers and devitalised tissues in the lower limbs
District Madeyski Hyperbaric Chamber 2003

2. Oxygen therapy
We can say that oxygen therapy has been the evolution of Hyperbaric therapy used in the last 30 years to treat different pathologies related to deficiencies of circulation and infection.
District Madeyski Hyperbaric Chamber 2003

3. Principles on which hyperbaric oxygen therapy is based
The Oxygen works by contact and because dissolved in the blood ( a modest increase is linked to the haemoglobin but a considerable increase is dissolved in the plasma)
District Madeyski Hyperbaric Chamber 2003

4. Principles on which hyperbaric oxygen therapy is based
Remember that in the Hyperbaric Chamber the atmospheric pressure is increased while the partial pressure of the oxygen remains invariable
District Madeyski Hyperbaric Chamber 2003

5. ULCERS AND DEVITALISED TISSUES
IN THE LOWER LIMBS
1) Venous stasis ulcers
2) Arterial ulcers
3) Traumatic ulcers
4) Collagenopatic ulcers
5) Diabetic ulcers
District Madeyski Hyperbaric Chamber 2003

6. THE THERAPIES 1) Medical therapy 2) Surgical therapy
3) Plastic surgery
4) Hyperbaric Chamber Therapy
District Madeyski Hyperbaric Chamber 2003

7. increase oxygen dissolved in the plasma
Hyperbaric Chamber
Advantages
Disadvantages
increase oxygen dissolved in the plasma
-Not for all people
-Cardiac,vestibular or cochlear tract, psychological problems
-Limited availably
-Problems with travelling distances
-No Availably of bed places
-Social and public costs
District Madeyski Hyperbaric Chamber 2003

8. District Normobaric Chamber
The Madeyski District Hyperbaric Chamber
District Normobaric Chamber
so called since resembling the Hyperbaric Chamber used by most important Medical Centres.
District Madeyski Hyperbaric Chamber 2003

9. District Normobaric Chamber No local or general contraindication.
The Madeyski District Hyperbaric Chamber
District Normobaric Chamber
Advantages
Disadvantages
increased oxygen in contact with the lesion
Minor increase by oxygen dissolved in the plasma
Rilevant Advantage:
No local or general contraindication.

10. The Madeyski District Hyperbaric chamber
District Normobaric Chamber
Advantages:
1) Patient satisfaction
2) Simple use and appreciation by paramedic staff
3) The lack of general contraindications.
4) The lack of local contraindications
5) Its reduced dimensions and easiness of transport
6) Its agreeable shape
7) Easily availability
8) The low cost of the device and its maintenance
9) Staff's quick training
10) Documented effectiveness

11. THE HYPERBARIC CHAMBER AND THE DISTRICT HYPERBARIC CHAMBER
DIFFERENCES BETWEEN
THE HYPERBARIC CHAMBER AND
THE DISTRICT HYPERBARIC CHAMBER
General hyperbaric chamber
District hyperbaric chamber
The Oxygen concentration reaches 22%
The Oxygen concentration reaches 95%
Oxygen dissolved in the plasma Vol 6 %
Oxygen dissolved in the plasma Vol 2%
District Madeyski Hyperbaric Chamber 2003

12. Differences between the hyperbaric chamber and the district hyperbaric chamber
Whilst in the hyperbaric chamber the treatment is through contact and dissolved oxygen in the plasma, in the district normobaric chamber the increase of dissolved oxygen in the plasma is lost
This missing effect is compensated by the increased oxygen concentration in the district normobaric chamber
The concentration, in fact, reaches 95% or a set value which therefore corresponds to 4 times the value found in the hyperbaric chamber.
District Madeyski Hyperbaric Chamber 2003

13. Differences between the hyperbaric chamber and the district hyperbaric chamber
But if an associated breathing in an oxygen mask is performed , the dissolved oxygen quota in the plasma increases without reaching the values due to hyperbarism.
2% Vol against 6% Vol
District Madeyski Hyperbaric Chamber 2003

14. Times of application of District hyperbaric chamber
Are different according to the
pathology and the local situation
Similarly the number of days in which
the therapy is applied is variable and
linked to the pathology and to others
contingent factors
District Madeyski Hyperbaric Chamber 2003

15. Times of application of District hyperbaric chamber
The average therapy is applied
for the duration of one hour, twice a day
Similarly the number of days in which
the therapy is applied is variable and
linked to the pathology and to others
contingent factors
District Madeyski Hyperbaric Chamber 2003

16. Past case histories
141 patients treated with chamber in an experimental period
During this period the chamber was not the definitive one
District Madeyski Hyperbaric Chamber 2003

17. Present experience District Madeyski Hyperbaric Chamber 2003
196 patients so divided:
1) 150 venous stasis ulcers
2) 12 Arterial ulcers
3) 5 Traumatic ulcers
4) 3 Collagenopatic ulcers
5) 22 Diabetic ulcers
6) 1 oncocarbide Ulcers
7) 13 patients with epidermic transplants
District Madeyski Hyperbaric Chamber 2003

18. Considerations for a correct evaluation
Results
Considerations for a correct evaluation
Since we are dealing with a chronic syndrome one can't reach a definitive recovery if the ethiology is not corrected identified.
District Madeyski Hyperbaric chamber 2003

19. Considerations for a correct evaluation
Results
Considerations for a correct evaluation
Sometimes,in subjects affected by peculiar pathology, a definitive recovery can not be reached.
District Madeyski Hyperbaric cCamber 2003

20. Results 1) Decrease of the secretions
2) Improvement of subjective sinthomatolgy
3) Improvement of objective sinthomatology
4) Cleaning of the lesions
5) Reduction of the diameters
6) Evidence of the granulation tissues since the third day of application
7) A positive result of the transplants expecially if Reverdin method is used
District Madeyski Hyperbaric Chamber 2003

21. The future … Portable device of contained cost for the house therapy
2) Nebulising for introduction
of drugs:
vaso dilatators –
healing
- for diabetic ulcers
3) Platelets concentrated
District Madeyski Hyperbaric Chamber 2003

22. Conclusions
The use of the Hyperbaric Chamber with a partial increased oxygen pressure is a very useful tool, at a low-cost and without contraindications for a large number of subjects with a large amount of devitalised or not very vital tissues ,due to local or general causes in the inferior limbs
District Madeyski Hyperbaric Chamber 2003