Cellulitis

 

BaroMedical CellulitisCellulitis is commonly caused by Strep or Staph bacteria and usually attacks people with poor peripheral vascular circulation such as in venous or arterial insufficiency, diabetes, pregnancy, obesity or result of an injury to the skin such as in burn, blister or animal bite or in people with lowered immune system such as post surgery. The infection can attack only superficial layers or it can spread deeper causing more serious problems (necrotising fasciitis, Fournier’s gangrene).

Cellutis manifests itself with swollen, inflammed skin covered with blistes and wounds that would usually heal with antibiotic therapy.

Hyperbaric oxygen therapy in treatment of cellulitis and necrotising fasciitis:

  • reduces pain and inflammation
  • reduces swelling
  • reduces infection and improves effect of antibiotics minimizing their side effect
  • speeds up wound healing
  • improves overall circulation which would minimize reoccurences
  • reduces mortality and amputation rate

Hyperbaric oxygen therapy in addition to antibiotics is successful in faster wound healing. In cases of deeper infections such as necrotising fasciitis, hyperbaric oxygen is limb and life saving and is routinely used when available.

Casefile: Cellulitis

Male 57 years old with history of recurrent cellulitis over last 6 years reported to hyperbaric unit 4 days after wounds opened.  He was prescribed antibiotics two days prior to HBO. He is suffering from hypertension and has been diagnosed as a borderline diabetic.

Client received 12 hyperbaric oxygen sessions over 14 days. Sessions were given at 2.0 ATA pressure of medical oxygen. Lower treatment pressure was decided due to clients hypertension. Each session was 90 minutes long and was given in mono-place oxygen flow hyperbaric chamber. Overall inflammation and swelling were reduced and wound closed over the two weeks of the therapy. (Please see Pictures below).

Hyperbaric oxygen therapy is generally recommended in peripheral vascular problems for wound healing, infection control, inflammation control and swelling.

Before HBO
BaroMedical Cellulitis before HBO lateral aspect BaroMedical Cellulitis before HBO lateral aspect
After 8 HBO
BaroMedical Cellulitis after 8 HBO BaroMedical Cellulitis after 8 HBO
After 12 HBO
BaroMedical Cellulitis after 12 HBO BaroMedical Cellulitis after 12 HBO
At two month follow up
BaroMedical Cellulitis at 2 month follow up BaroMedical Cellulistis at two month follow up


References:

  1. Escobar SJ, Slade JB, Hunt TK, Cianci P:. Adjuvant hyperbaric oxygen therapy (HBO2) for treatment of necrotizing fasciitis reduces mortality and amputation rate, Undersea Hyperb Med 32 (6): 437–43, 2005.
  2. de Vaumas C, Bronchard R, Montravers P: Non pharmacological treatment of severe cutaneous infections: hyperbaric oxygen therapy, dressings and local treatments; Ann Fr Anesth Reanim. 2006 Sep;25(9):986-9.
  3. Mathur MN, Patrick WG, Unsworth IP, Bennett FM. Cellulitis owing to Aeromonas hydrophilia: treatment with hyperbaric oxygen; Aust N Z J Surg, May;65(5):367-9, 1995.
  4. Brown DR, Davis NL, Lepawsky M, Cunningham J, Kortbeek J A multicenter review of the treatment of major truncal necrotizing infections with and without hyperbaric oxygen therapy. Am J Surg. May;167(5):485-9,1994.
  5. Hirn M: Hyperbaric oxygen in the treatment of gas gangrene and perineal necrotizing fasciitis; A clinical and experimental study.Eur J Surg Suppl;(570):1-36. Review, 1993.
  6. Topper SM, Plaga BR, Burner WL 3rd: Necrotizing myonecrosis and polymicrobial sepsis. The role of adjunctive hyperbaric oxygen;Orthop Rev. Oct;19(10):895-900,1990.
  7. Hirn M, Niinikoski J: Hyperbaric oxygen in the treatment of clostridial gas gangrene; Ann Chir Gynaecol; 77(1):37-40, 1988.
  8. Cohn GH: Hyperbaric oxygen therapy. Promoting healing in difficult cases; Postgrad Med. Feb 1;79(2):89-92, 1986.
  9. Jacobsen E, Secher O: Hyperbaric oxygen therapy in anaerobic infections; Nord Med.;86(46):1339-42, 1971.in Danish.
  10. Hitchcock CR, Haglin JJ, Arnar O: Treatment of clostridial infections with hyperbaric oxygen: Surgery, Oct;62(4):759-69, 1967.
  11. Douso ML: Hyperbaric oxygen therapy as adjunctive treatment for postoperative cellulitis involving intrapelvic mesh;.J Minim Invasive Gynecol, Mar-Apr;16(2):222-3, 2009.
  12. Higuchi T, Oto T, Millar IL, Levvey BJ, Williams TJ, Snell GI: Preliminary report of the safety and efficacy of hyperbaric oxygen therapy for specific complications of lung transplantation.; J Heart Lung Transplant. Nov;25(11):1302-9,2006.
  13. Wang J, Corson K, Mader J: Hyperbaric oxygen as adjunctive therapy in Vibrio vulnificus septicemia and cellulitis. Undersea Hyperb Med, Spring;31(1):179-81,2004.

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