Introduction: Limb injury is a major health concern that imposes a direct danger to both life and limb viability. At Kandou Hospital Manado, hyperbaric oxygen (HBO) therapy has been performed as an adjunctive treatment for crush injury although no study has yet directly compared outcomes of HBO versus conventional therapy. Documentation of the association between HBO therapy and the healing process of crush injury is necessary to reduce the gaps in the literature and to establish an evidence-based clinical use of HBO therapy. Methods: In this study, we assessed the changes in the vascular endothelial growth factor (VEGF) serum levels and VEGF mRNA expression as biomarkers of wound healing using ELISA and qRT-PC at four different measurement times: at baseline, after receiving initial treatment (debridement and limb-salvage surgeries), 2 h after the first session HBOT, and after a full 10 HBOT sessions. A randomized controlled trial (RCT) was used to enroll patients subjected to crush injury who were admitted to the Surgical Emergency Department (ER) of Kandou Hospital Manado, Indonesia. Results: VEGF serum levels increased significantly in patients suffering from crush injury who received HBO therapy versus the control group. The increased VEGF serum is expected to result in an acceleration time of wound healing and a reduction in amputation rate. Conclusion: There was a significant difference between crush injury patients who received conservative therapy versus those receiving HBO therapies; thus, there was an increased likelihood of an accelerated wound healing and a reduction in the risk of amputation. Highlights

Introduction Ischemia-Reperfusion Injury (IRI) is a complication following the reperfusion of ischemic tissues; it requires immediate treatment, as it can lead to severe infection and tissue death. The purpose of this study was to demonstrate the ability of Hyperbaric Oxygen Therapy (HBOT) to treat SIRS (Systemic Inflammatory Response Syndrome) caused by IRI and to provide long-term functional assessment for a period of up to 5 years. Case presentation Two cases of avulsions of the hand at the levels of the wrist joint and the medial third forearm, severed by machetes. Both patients were male and in their twenties. Hand replantation was carried out after 30 minutes (medial third forearm case) and 11 hours (wrist joint case) of ischemic time. A couple of days after surgery, both patients experienced SIRS as a result of IRI. The patients were brought to the hyperbaric chamber and received 3 consecutive 90-min sessions of HBOT at 2.4 ATA 3 days in a row. The outcomes were compared in a table with each patient's vital signs and laboratory results, both before and after HBOT. A significant improvement was seen at the follow-ups in vital signs and laboratory results for both patients after HBOT administration. Long-term follow-up also showed satisfying results for hand function, proven by low DASH (Disabilities of the Arm, Shoulder, and Hand) scores. Conclusion HBOT was able to treat SIRS in both patients. Favorable long-term hand function results signify successful extremity replantation.

Besides decompression sickness, hyperbaric oxygen therapy can be used as a therapeutic modality of several diseases inter alia wound healing in gangrene, compromised grafts and flaps, crush injuries, thermal burns, and intracranial abscess. This study was aimed to obtain the usage of hyperbaric oxygen therapy in healing process as indicated. This was a descriptive retrospective study using data of patients who had hyperbaric oxygen therapy performed on them at Prof. Dr. R. D. Kandou Hospital from 2013 to 2016. The results showed that there were 128 patients that had hyperbaric oxygen therapy performed on them,consisted of decompression sickness in 60 patients (46.87%), thermal burn in 29 patients (22.65%), diabetic ulcer in 19 patients (14.84%), followed by crush injury, skin graft, and pre-post amputation in 6 patients each (4.68%), and gangrene in 2 patients (1.56%). Conclusion: The usage of hyperbaric oxygen therapy for decompression was 46.87% and for wound healing was 50.13%.Keywords: hyperbaric oxygen therapy, wound healing Abstrak: Terapi oksigen hiperbarik (TOHB) merupakan salah satu modalitas terapi tambahan yang bisa digunakan sebagai modalitas terapi dari beberapa penyakit selain decompression sickness yaitu penyembuhan luka seperti pada gangrene, compromised grafts and flaps, crush injuries, thermal burns, dan intracranial abscess. Penelitian ini bertujuan untuk mengetahui seberapa banyak penggunaan terapi oksigen hiperbarik sebagai salah satu modalitas terapi pada proses penyembuhan penyakit yang termasuk dalam indikasi. Jenis penelitian ialah deskriptif retrospektif menggunakan data pasien yang melakukan TOHB di RSUP.Prof. Dr. R. D. Kandou periode tahun 2013-2016. Hasil penelitian mendapatkan 128 pasien yang menggunakan TOHB sebagai berikut: decompression sickness sebanyak 60 pasien (46,87 %), luka bakar sebanyak 29 pasien (22,65%), ulkus diabetik sebanyak 19 pasien (14,84%), diikuti crush injury, skin graft dan pre-post amputation masing-masing sebanyak 6 pasien (4,68%), dan gangren 2 pasien (1,56%). Simpulan: Penggunaan TOHB untuk dekompresi sebanyak 46,87% dan untuk penyembuhan luka sebanyak 50,13%. Kata kunci: TOHB, decompression sickness, penyembuhan luka

Introduction: Post-concussion syndrome is common in young adults and can greatly interfere with the quality of daily life. It has a wide range of symptoms that require prompt and well-targeted treatment to avoid further brain impairment. Hyperbaric oxygen therapy (HBOT) is a promising regenerative treatment option for these patients to help prevent the progression of post-concussion syndrome. This study aims to determine whether HBOT accelerates the healing process and reduces symptoms in patients with post-concussion syndrome.  Methods: 20 patients with post-concussion syndrome participated in this randomized controlled trial study. After receiving standard mild traumatic brain injury treatment in accordance with the Advanced Trauma Life Support guidelines, the patients were divided into HBOT and control groups. Matrix metallopeptidase 9 (MMP-9) levels and Rivermead Post-Concussion Symptoms Questionnaire (RPQ) scores were used to compare the two groups (before HBOT & after 1st, 3rd, and 5th week).  Results: The study sample was predominantly male (65%) with an average age of 60 years old. HBOT reduced serum MMP-9 levels by nearly 20 ng/mL (p < 0.001) compared with the control treatment. The efficacy of HBOT was also reflected in the RPQ scores, which were significantly lower in the HBOT group than the control group (before HBOT & after 1st, 3rd, 5th week) (-3.80 on RPQ-3, p = p<0.001; -16.20 on RPQ-13, p = p<0.001).  Conclusion: HBOT ameliorated the symptoms associated with post-concussion syndrome through a mechanism that involves MMP-9 activity. The accelerated recovery observed in the present study supports the use of HBOT to treat post-concussion syndrome and potentially other forms of traumatic brain injury.

No abstract