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Oxygen therapy venous stasis ulcers and
devitalised tissues in the lower limbs
District Madeyski Hyperbaric Chamber 2003
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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
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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
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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
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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
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THE THERAPIES
1) Medical therapy 2) Surgical therapy 3)
Plastic surgery 4) Hyperbaric Chamber Therapy
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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
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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
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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.
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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
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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
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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.
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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
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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
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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
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Past case histories
141 patients treated with chamber in an
experimental period During this period the
chamber was not the definitive one
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Present experience
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
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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.
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Results
Considerations for a correct evaluation
Sometimes,in subjects affected by peculiar
pathology, a definitive recovery can not be
reached.
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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
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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

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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