Chronic refractory osteomyelitis (CROM) consists of an infection of bone tissue or bone marrow that is quite difficult to treat via the conventional modes of treatment. With both antibiotics and surgical removal ineffective, the pathogens that cause the condition continue to reside in the bone thus making recovery difficult. Those who are most susceptible to bone infections include individuals suffering from the following conditions/situations: diabetes, sickle cell anemia, and other blood infections, as well as those who have undergone corrective procedures such as hip replacements and bone implants. Some of the most common symptoms of the conditions include excessive swelling, pain and inflammation, and difficulty while using limbs, among others. The condition has high morbidity and mortality as well as reduced quality of life which could include limited movement.
Mechanism of Action for Hyperbaric Oxygen Therapy (HBOT)
Hyperbaric oxygen (HBO) is mostly applied in instances where other treatments such as surgical procedures and antibiotics have been unsuccessful. Healing options and pathways are increased once the bone tissues are supercharged with oxygen. Bone tissue oxygenation improves the overall immune system of the body. Strong immunity plays a key role in the regeneration of new bone tissue. There is a reversal of the oxygen-insufficient situation since CROM leaves the body with minimal oxygen proportions, especially in the bone tissues. This aids in increased efficiency and better outcomes with other forms of treatment that were initially ineffective. Increased white blood cell activity as well as high oxygen tension enhance the conveyance of antibiotics across the cell walls of the bacteria leading to bone infections; the antibiotics can only be transported across the cell walls at certain oxygen tension levels. The bacterial count is effectively lowered and wiped out. Once neutrophils get rid of the disease-causing microorganisms, other forms of treatment become effective. The pre-existing conditions with the high oxygen supply make it unbearable for such bacteria as Staphylococcus aureus to survive; the latter is the most popular pathogen that is highly attributed to the contraction of CROM.
The oxygen also improves the bone mineralization process thus leading to stronger bones and bone tissue. Infections and bone tissue necrosis are avoided as well. Also, increased oxygenation leads to collagen synthesis as well as neovascularization. The rebirth of capillaries takes place around the oxygen-deprived bone and nearby tissues thus making sure they receive enough oxygenated blood and nutrients. Bone tissue oxygenation improves the overall immune system of the body. Strong immunity plays a key role in the regeneration of new bone tissue. There is a reversal of the oxygen-insufficient situation since CROM leaves the body with minimal oxygen proportions, especially in the bone tissues. This aids in increased efficiency and better outcomes with other forms of treatment that were initially ineffective. Overall, HBOT improves the quality of life as well as reducing rates of recurrence of CROM. It is safe for use for individuals of all ages with minimal to zero cases of resulting complications. It reduces instances of amputations that result from poor recovery for bone health issues.
References
Savvidou, O. D., Kaspiris, A., Bolia, I. K., Chloros, G. D., Goumenos, S., Papagelopoulos, P. J., & Tsiodras, S. (2018). Effectiveness of hyperbaric oxygen therapy for the management of chronic osteomyelitis: A Systematic Review of the literature. Orthopedics, 41(4), 193–199. https://doi.org/10.3928/01477447-20180628-02
Shields, R. C., Nichols, F. C., Buchta, W. G., & Claus, P. (2010). Hyperbaric oxygen therapy for chronic refractory osteomyelitis of the sternum. The Annals of Thoracic Surgery, 89(5), 1661–1663. https://doi.org/10.1016/j.athoracsur.2009.10.018
Comments