Dr. Stone is the past medical director of the Hyperbaric Medicine Unit located at the Institute for Exercise and Environmental Medicine at Presbyterian Hospital of Dallas. This unit is one of the largest and most advanced hyperbaric treatment facilities in the world and demonstrates the hospital’s commitment to this specialized area of wound care. Dr Stone is also the fellowship director for the Hyperbaric medicine Fellowship. This is only one of seven facilities in the U.S. that is an ACGME approved fellowship.
The hyperbaric chamber at Presbyterian Hospital is 40 feet long and 9 feet in diameter. The multiplace chamber can accommodate seven patients at one time and there are three treatment cycles each day. About 40% of the patients have diabetes but many of the others are radiation patients. There is an advanced computer system that monitors all operations and the chamber also includes medical emergency equipment including cardiac monitoring, suctioning and mechanical ventilation. It even includes a large screen TV so that patients can watch movies during their treatment.
But how does it work? Hyperbaric oxygen therapy, or HBO, is administered by pressurizing the chamber with air to an equivalent of 2.4 atmospheres while the patients are breathing 100% oxygen through a mask or hood. The increase in the level of oxygen delivered to the tissues through this method helps to augment wound-healing repair.
Hyperbaric oxygen therapy has been approved as the primary mode of therapy for air or gas embolism, decompression sickness and carbon monoxide poisoning. But, it is used the majority of the time for approved adjunctive treatments which include radiation tissue damage to include Soft tissue radionecrosis, osteoradionecrosis radiation cystitis and proctitis , gas gangrene, compromised skin grafts and flaps, crush injuries or acute traumatic ischemia, necrotizing soft tissue infections, osteomyelitis and diabetic foot and other problem non-healing wounds.
Its success in treating diabetic foot wounds as related to limb salvage has been proven through extensive research comparing standard treatments to HBO treatments.
Our published research results showed that the limb salvage rate of the HBO patients, despite having more serious wounds, was greater than the limb salvage rate of patients receiving standard care, specifically 72% for the HBO patients and 53% for the standard care patients.
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