Treatment of rheumatoid vasculitic cutaneous ulcers with regional hyperbaric oxygen

Hyperbaric oxygen therapy (HBO) has been used to promote healing of cutaneo us ulcers secondary to diabetes mellitus, ionized radiation exposure injuri es, gas gangrene, crush injuries, and necrotizing fasciitis. Despite the be neficial effects of HBO, there have been conflicting clinical experiences r eported regarding its efficacy. To evaluate the effects of localized HBO, e ight patients who were referred to a vascular surgery service with nonheali ng rheumatoid vasculitic cutaneous ulcers were placed on a regional HBO reg imen consisting of 100% fraction of inspired oxygen at 2x atmospheric press ure for 60-90 minutes three times daily. Wound healing occurred in 87.5% of patients with a mean healing time of 4.7 weeks (range 2-10 weeks). The aut hors conclude that localized HBO for the treatment of refractory rheumatoid vasculitic ulcers is a safe and expedient modality to be considered and th at these chronically hospitalized patients, exhausting other treatment regi mens, may benefit from HBO therapy.