CRUSH INJURY

Crush injury is a diffuse traumatic injury involving tissues with a gradient of injury and compromised blood supply. The primary insult is tissue ischemia and cellular hypoxia. Secondary effects of vasodilation at the pre-injury level lead to increased edema and further vascular compromise thus affecting the tissue's ability to handle infections.

Optimal response is evident if treatment is initiated within six hours of injury. When used as an adjunct to orthopedic surgery and antibiotics, hyperbaric oxygen therapy shows promise as a way to decrease complications from severe crush injuries. HBO increases oxygen delivery to the injured tissues, reduces swelling and provides an improved environment for healing and fighting infection.

Hyperbaric oxygen treatments should be started as soon after an injury as possible. They are usually continued for 5 to 6 days.

HBOT

• Increases oxygen tension leading to greater capillary oxygen diffusion distances.
• Produces a vasoconstriction that reduces edema formation.
• Has an indirect effect on leukocyte enhancement and increased wound healing. Decreases neutrophil adhesion & activation in the ischemic-reperfused tissue.