Hyperbaric oxygen has come a long way from its roots of being used for decompression illness suffered by divers, and tunnel workers and bridge builders who suffered from caisson’s disease.
Director of Royal Adelaide Hospital Hyperbaric Medicine Unit, Dr David Wilkinson states that 80% of the work undertaken is now for medical treatment.
“Non-healing wounds such as ulcers in elderly people, particularly diabetics or people who have impaired blood flow to their legs and are prone to getting ulcers that are hard to heal.
A large group of patients we also treat are people who have had radiotherapy; radiotherapy is a very effective treatment for cancer and that continues to be the case. Unfortunately one of the side effects of the radiotherpay is it can damage the normal tissue thats subjected to that radiation. That normal tissue then undergoes a recognised pattern of injury and can lead to problems within the health and lifestyle of the people who have had it.
There has been very little that has been known that you can do with the damage by the radiotherapy and practically the only therapy that has been shown to reverse the damage of radiotherapy is hyperbaric oxygen.
We are working in a field where there is little else to offer people in that regard and we are improving the science and our understanding of how it works, radiotherapy is one of our increasing fields of interest and it will continue to be so. Other things we treat is carbon monoxide poisonings and nasty infections like what we call necrotising tissue infections or necrotising fasciitis; what the press sometimes report as flesh-eating bug disease.”
On body responses to hyperbaric oxygen…
“In days gone by, people used to think of putting a person into a hyperbaric chamber; under pressure, breathing 100% oxygen, you’d get this big dose of oxygen that you would breathe in and it would be distributed through the body and it would be that extra dose of oxygen that would overcome the problem. A fairly simplistic idea that more oxygen made you better.
There is a small add-along to that, but if that was the only rationale for people getting better, then you would expect them to go back to square one as soon as they came out of the chamber. Now we know that doesn’t happen, and more and more we have been increasingly recognising that the course of hyperbaric treatment; that is a day-to-day exposure to hyperbaric oxygen environment leads to more fundamental changes in the way the body works – more than just the physical presence of oxygen.
The sort of changes we are talking about are changes in cell function; we are talking about changes in the way the cells behave in healing wounds. There is a class of cells called fibroblasts which lay down a substance called collagen which is like a scaffold on which scar and tissue repair occurs. Hyperbaric oxygen has been known to increase the activity of fibroblast cells and increase the amount of collagen they produce. At the same time, repeated exposure to hyperbaric oxygen can lead to the growth of new blood vessels into tissue that has poor blood supply.
Interestingly enough, the tissue that has normal blood supply doesn’t respond in that way; it only seems to be the tissue that has a poor blood supply that allows a growth of new blood vessels into that. So what we are seeing now is the recognition that the hyperbaric oxygen can lead to a whole series of changes in cell function, which are ongoing and permanent after the completion of hyperbaric, rather than just something that has happened due to the physical exposure to the oxygen at the time.”
Dr David Wilkinson goes on to explain how medical thinking evolved in the 1950’s and 60’s where hyperbaric oxygen was being used for coal mining accidents to treat carbon monoxide poisoning and what followed on was its use for nasty infections like gas gangrene, and then in the early days of open heart surgery, it was used to heavily oxygenate the patient to allow them to undergo the operation.
Through this period of scientific investigation, Dr Wilkinson and his team at the RAH Hyperbaric Medicine Unit are now heavily involved in the field of research and designing appropriate studies that demonstrate how clinically effective hyperbaric oxygen is and states “we still have some way to convince all of the medical authorities and beaurocrisy that indeed it [hyperbaric oxygen] is an effective treatment and is worthy of pursuing”.
One such study showing promising results for medical use of hyperbaric oxygen and therefore improving consideration as the treatment of choice is for Bell’s Palsy; a post viral problem that can lead to facial droop.
To learn more, visit the ABC article which features a downloadable mp3 video of the full interview with Dr. Wilkinson.