Review of systemic lupus erythematosus

This article reports the results of a clinical study of 41 patients with ma ndibular osteoradionecrosis. Patients were divided into research arms to re ceive either post resection (of the radiation-damaged bone) hyperbaric oxyg en (HBO) treatment, repeated debridement and clindamycin, or debridement an d clindamycin without HBO. Assignment to HBO and no HBO groups was based on the availability of HBO at participating institutions. It is unclear from the article what means were used to standardize debridement protocols and s uccess criteria. The authors found that patients receiving HBO not only did not receive a be nefit, but also had poorer outcomes than did those not receiving HBO. The a uthors concede that the study numbers are relatively low but conclude that HBO should not be recommended for treatment of severe osteoradionecrosis af ter an initial resectioning of the involved mandible. They do appear to rec ommend following the protocol of preoperative and postoperative HBO for pre vention and preresection of osteoradionecrosis.