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Hyperbaric chambers encourage the healing of chronic wounds

Oxygen supports immune system, growth factors
Rachelle Nadeau, hyperbarics technologist at the Wound Care Center at Mercy Regional Medical Center, monitors Jim Harvey during his treatment in a chamber recently. Harvey is receiving treatment for a chronic wound in his foot. Hyperbaric chambers allow patients to breathe in more oxygen, which prompts the creation of new blood vessels and supports the immune system.

A wound in Durangoan Jim Harvey’s foot caused an infection that nearly killed him six years ago. Now, he is battling a wound in the same spot that he expects will close faster and heal without a life-threatening infection.

Hyperbaric oxygen chambers at the Wound Care Center at Mercy Regional Medical Center are helping to speed his healing time by flooding his body with oxygen, said Rachelle Nadeau, hyperbarics technologist at the Wound Care Center operated by Healogenics.

The chambers increase the amount of oxygen in the air surrounding patients, allowing them to breathe in more oxygen molecules, she said. Breathing in more oxygen in turn floods a patient’s blood stream with oxygen, she said.

The increase in oxygen prompts the creation of new blood vessels, she said. It also supports the immune system and increases the release of growth factors, according to the Mayo Clinic.

The Wound Care Center at Mercy Regional Medical Center uses two single-person hyperbaric chambers to encourage the healing of chronic wounds, which are those that have persisted for at least six months. Rachelle Nadeau is a hyperbarics technologist at the center.

“It looks very relaxing in there, and it is very relaxing to the patient. But their body is working super hard to carry all of that oxygen to their whole body,” Nadeau said.

In addition to wounds, hyperbaric oxygen chambers can help those with burns, gangrene and bone death resulting from radiation, according to the Mayo Clinic.

The center operates two single-person chambers that are constantly monitored by center staff while they are in use. Patients can experience barotrauma, or decompression sickness, from the changing air pressure in the chambers, which can harm a patient’s inner ear and lungs. Patients can avoid barotrauma by popping their ears as the pressure increases and decreases in the chambers.

Because of the high concentration of oxygen, the chambers also pose a fire danger. Patients are not allowed to take anything with them into the chambers and must wear bracelets to prevent static electricity discharging from the body and starting a fire, Nadeau said.

Healing without hyperbarics

The Wound Care Center had yet to open when Harvey first cut his foot six years ago by stepping on his wife’s razor in a tub. So, Harvey, now 70, received IV antibiotic treatments for days at a time to fight infection and saw a surgeon to remove unhealthy tissue from his wound, he said.

For a year and a half, his foot continued to swell with infection periodically. In May 2014, he got a 104-degree fever and went to the hospital with sepsis.

“I could have gone either way as far as living or dying,” he said.

Rachelle Nadeau, hyperbaric safety director at the Wound Care Center at Mercy Regional Medical Center, talks to Jim Harvey during his treatment for a chronic wound. Harvey’s treatment required him to spend two hours in a hyperbaric chamber Monday through Friday for 12 weeks.

IV antibiotics saved his life, but the root cause of the problem wasn’t discovered until December 2014, when a CT scan showed the bone in his foot was infected. Previously, MRI and CT scans had failed to reveal the problem because he is unable to hold his foot still, he said.

Six weeks of daily IV antibiotic treatment cleared up his infection and helped his wound to heal. The year-and-half of treatment cost Harvey $30,000 out of pocket with insurance, he said.

If the wound center had been open, he said he believes the bone infection would have been caught earlier.

A new wound

This year, Harvey’s current wound may have opened while he was shoveling snow over the winter. But he couldn’t feel it because of neuropathy in his feet.

In May, he went to the emergency room for muscle pain near his groin and discovered he had a “raging infection” in his foot and leg, stemming from a wound in the same spot as the original one.

Jim Harvey says his hyperbaric oxygen treatment at the Wound Care Center at Mercy Regional Medical Center has reduced a wound on his foot from dime-sized to the size of a cut.

After IV antibiotic treatment and a few months of hyperbaric treatment, his wound is closing, he said. The treatment requires him to spend two hours in the chamber Monday through Friday for 12 weeks, but it’s not getting him down.

“The people at the wound clinic, they are sort of my second family,” he said.

When the wound closes, Harvey says he’ll be monitoring his foot closely to ensure he can catch a new wound earlier.

“I am going to be taking a photo of it every day for the rest of my life,” he said.

The wound started out dime-sized and has been reduced to a cut, he said. The feeling in his feet has also largely returned, he said. This time, the treatment was covered by Medicare and his supplemental insurance.

‘Tangible field of medicine’

The wound care center, which opened in 2015, sees patients with spider bites, crush injuries, pressure ulcers, surgical wounds, and diabetic patients with wounds that will not close, said Elizabeth Santaniello, wound care specialty provider and family nurse practitioner.

“Most wounds that are chronic and nonhealing are stuck in what we call the inflammatory phase,” she said.

In addition to treating chronic wounds, the two hyperbaric oxygen chambers at the Wound Care Center at Mercy Regional Medical Center can help people with burns, gangrene, brain injuries and bone death resulting from radiation.

A wound is considered chronic if it has not healed within six weeks, she said.

In addition to the hyperbaric chamber, the center uses other methods to help wounds heal, including removing dead tissue and in some cases applying an Apligraf, which is made of human cells.

The cells contain proteins and collagen that can encourage the healing process, but not hair follicles, sweat glands or blood vessels found in skin, according to Organogenesis, the maker of the product. The Apligraf is laid over the wound and then the area is wrapped to keep it in place.

“It’s not a paint job. It is a stimulation product to get your natural skin to heal,” Santaniello said.

Cortez resident Cathie Everett said an Apligraf closed a wound the size of a 50-cent piece on her leg in three months.

Santaniello started at center in January, and since then, she has seen a surge of new younger patients, a trend she attributes to better outreach by the staff.

It’s work she said she enjoys because it is a tangible field of medicine: “The wound is right in front of me, and we can all look and say; ‘Has this healed?’”

mshinn@durangoherald.com

This story has been updated to correct several errors. There is insufficient evidence to show hyperbaric oxygen therapy can help those with brain injuries. Wounds are considered chronic after six weeks, not six months. The surge in new patients at the Wound Care Center has been among younger patients. Most of the patients the center works with are older.



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