Treatment of Rheumatoid Vasculitic Cutaneous Ulcers with Regional Hyperbaric Oxygen

Abstract

Hyperbaric oxygen therapy (HBO) has been used to promote healing of cutaneous ulcers secondary to diabetes mellitus, ionized radiation exposure injuries, gas gangrene, crush injuries, and necrotizing fasciitis. Despite the beneficial effects of HBO, there have been conflicting clinical experiences reported regarding its efficacy. To evaluate the effects of localized HBO, eight patients who were referred to a vascular surgery service with nonhealing rheumatoid vasculitic cutaneous ulcers were placed on a regional HBO regimen consisting of 100% fraction of inspired oxygen at 2 x atmospheric pressure 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 authors conclude that localized HBO for the treatment of refractory rheumatoid vasculitic ulcers is a safe and expedient modality to be considered and that these chronically hospitalized patients, exhausting other treatment regimens, may benefit from HBO therapy.