Stellenwert der hyperbaren Oxygenierungstherapie (HBO) in der Unfallchirurgie

Abstract

Hyperbaric oxygen therapy (HBOT) is defined asthe administration of 100% oxygen in a thera-peutic compression chamber. The increasedambient pressure of 2–3 atmospheres inducesplasma oxygen concentrations of up to 1,600mmHg and thus increases tissue oxygenationeven in tissues with impaired microcirculation.The effects of HBOT in surgery are confirmed: itreduces tissue oedema, stimulates wound heal-ing, especially in patients with impaired immunestatus, stabilises microcirculation, triggers angio-genesis, kills anaerobic bacteria and oxygenateshypoxic tissues. HBO is indicated as a first-line oradjuvant therapy in trauma surgery for suchselected conditions as decompression sickness,arterial gas embolism, carbon monoxide poison-ing and important surgical problems, e.g. necro-tising soft tissue infection, intracranial abscess,crush injury and specific problem wounds.Hyperbaric oxygen is a safe and helpful proce-dure, especially for trauma patients. It reducestreatment costs by shortening the length of hos-pital stay and lowering the risk of complications.