Acute Traumatic Ischemias: Roles of Hyperbaric Oxygen

Acute traumatic ischemias are a constellation of disorders that range from crush injuries to compartment syndromes, from burns to frostbite, and from threatened flaps to compromised re-implantations. They represent a significant economic burden to the health care system. In 2016, the National Trauma Organization reported that $672 billion was spent on trauma care without consideration for loss of employment income and psychological trauma associated with the problems. In the most severe orthopedically related traumatic ischemias, for example, Gustilo Grade III-B & C open fractures [1]. Fifty percent complication rates occur even with state of the art orthopaedic and other optimal ancillary care. Hyperbaric oxygen (HBO₂) has mechanisms that mitigate the pathophysiology of the traumatic ischemias with the potential for improving those that have predicably less than optimal outcomes. This selection discusses the surgical types of traumatic ischemias, focusing primarily on crush injuries. It is noteworthy that all the traumatic ischemias have similar pathophysiology. Other sections of this Hyperbaric Medicine Indications Manual are specifically devoted to burn injuries and threatened flaps and grafts.