Wound Healing and Infections

The use of Hyperbaric Oxygen therapy to overcome infections

The development of anti-bacterial drugs was a turning point in human history. Starting in the middle of World War II and advancing until today, the mass production of antibiotics has made ease of what was once a terrifying prospect.

But challenges still remain. In spite of continued research and development, some kinds of infections prove resilient, and not everyone can tolerate the doses or durations required for successful treatment of their infection.

Anaerobic infections live in low-oxygen environments, and consequently tend to be out of reach for standard antibiotic treatment options. Bone infections, for instance, are difficult to treat because there is not as much blood flow in bones as in, for instance, skin or organs. Another example is someone with diabetes or other condition’s that can cause poor circulation resulting in wounds, such as foot ulcers, that never seem to heal.

On top of that there are novel infections like fungus, which cannot be harmed by antibiotics and are sometimes resistant to anti-fungals, or Clostridium perfringens which kills tissue with intense doses of toxins, leading to gas gangrene, a condition that requires swift intervention.

Hyperbaric Oxygen Therapy (HBOT) is a safe, effective adjunctive therapy used by our naturopathic doctors at the Nardella clinic in Calgary when treating infections, and is especially useful in the difficult cases described above. The sooner HBOT is introduced into the treatment regimen, the better the outcome will be, shortening the time it takes to heal and helping to treat bacterial and fungal infections.

HBOT works directly by killing anaerobic bacteria, which lacks antioxidant defence and are thus overwhelmed and destroyed by the sudden, massive increase in oxygen around them. HBOT works indirectly by increasing your body’s natural ability to seek and kill invaders and clear toxins, by simply increasing the amount of oxygen in your body and triggering it to produce collagen and various immune and “helper” cells.

In short, HBOT speeds up your factories and your delivery network while lending a hand in the fight.  Even when dealing with aerobic bacteria – the kind that thrives in oxygen – Hyperbaric Oxygen Therapy has an edge over standard treatments alone. HBOT increases tissue oxygenation to a point that it interferes with the bacteria’s ability to synthesize the chemicals they need to grow and reproduce, effectively halting them while antibiotics and your immune system kill them off.

Diabetics, the elderly, people with poor circulation, the very young, and anyone who suffers chronic infections or cannot, for whatever reason, go through a long, high-dose course of antibiotics would benefit from Hyperbaric Oxygen Therapy.

Osteomyelitis

For most of us the word “infection” brings about images of hot, red wounds in our skin, or the fabled days before antibiotics when as many soldiers died of wounds as they did immediately in battle. “Infection” has lost much of its horror in the face of potent drugs and widespread knowledge about bacteria and cleanliness in our privileged part of the world.

Still, there is always room to know more, and our respect and awareness for potentially harmful bacteria should never decrease. This brings us to osteomyelitis, infection of the bone or bone marrow caused in most cases by staphylococcus bacteria, commonly known as “staph”. This particular bacteria is found on our skin whether we are healthy or not, and typically causes no issues, but will exploit any opportunity it can.

We often think of our bones as the unshakable foundation of our physical being, strong and deep enough to be nearly untouchable, unaffected by the myriad issues that affect more surface organs. What we forget is that our bones are fed by the same blood as every other corner of our bodies, and are thus susceptible to whatever that blood is carrying. If, for instance, a urinary tract infection gets into the bloodstream it could find a weak spot in a bone. On top of that, conditions affecting the oxygenation or flow of the blood, or immune system as a whole — think diabetes and chemotherapy for example — can increase the risk of infection.

Bones are, of course, not invincible, and can break or sustain other damage a variety of ways, from blunt impact to penetrating wounds. Especially in the case of penetration or compound fracture, the inner parts of the body are open and vulnerable. If the wound becomes infected, it could more easily spread to any nearby bone. Surgeries are another way that bacteria can be delivered directly to bone or close to it.

Symptoms of osteomyelitis are similar to other types of infection: fever or chills, pain, warmth, and redness over the infected area, and so on. An important difference is that infected bone could show a decrease in range of movement, thus impacting quality of life and ability to perform activities that the sufferer once could. If not cured quickly enough osteomyelitis can become chronic, a condition with less intense but more gnawing, persistent symptoms.

Appropriate antibiotics are the key, as they are in most cases of bacterial infection. The challenge encountered is that infected bone has less oxygen and blood flow than standard tissue. Indeed, bone receives less blood flow even at the best of times, making delivery of drugs more difficult.

This is where our Calgary naturopathic doctors come in…..Hyperbaric oxygen therapy. Hyperbaric Oxygen Therapy (HBOT) is a great complement to standard medical treatment with antibiotics. Not only can it return oxygen and blood flow to normal (or better), it also increases the killing power your body possesses against the bacterial invaders. Results of clinical studies in this area are exciting. For example, HBOT cured 70% of patients with spinal osteomyelitis complicated with other conditions or that had failed to respond to conventional treatment alone according to the research.

It is important to use all the best tools available to resolve negatively life-altering conditions such as osteomyelitis as soon as possible. Along with antibiotics and other standard treatments, Hyperbaric Oxygen Therapy is a great adjunctive therapy for osteomyelitis.

Wound Healing

We take for granted that our body heals itself. We get a scratch from a nail, cuts from scissors, and burns from a skillet, then take care of the wound as best we know how. After that we do not think about it. In a few days we see significant change, and perhaps even complete healing.

The moment a wound causes damage to a blood vessel a complex chemical cascade begins. When you snip your finger with scissors you only perceive your blood exposed to the open air. What you do not see is a host of cells mobilizing. Platelets activate and start clumping to form a clot, white blood cells attack any enemy microbes trying to get in, macrophages clear dead or obstructive tissue. Next come the fibroblasts and other cells to start building new blood vessels and knitting things back together. The clotted material, which has formed a scab, eventually falls off.

It happens with speed and precision all on its own. But there are certain ingredients and conditions required for the process to proceed unimpeded and have a positive outcome. Even if the body has all the proper nutrients, delivering them to the site of the wound is another matter. And if the immune system is unable to fend off invaders, infection will also complicate the healing process.

Slow healing wounds are at risk of infection. Increasing pain and inflammation, fever, and oozing pus are all signs to be aware of. The wound may need professional attention at that point.

Several conditions can impede blood flow: diabetes, obesity, peripheral arterial disease, disability of the wounded limb, and even the inflammation brought on by the wound itself are a few examples. Anything that impedes blood flow to a wound causes hypoxia (insufficient oxygen) at the site. Oxygen, as we all know, is required for every function in the body. Its absence or inadequacy prevent normal healing.

HBOT exposes the body to 100% oxygen at pressures higher than we experience in our daily lives. This process forces oxygen to dissolve in plasma — the liquid part of blood — saturating the entire body as blood flows across tissue.

Super oxygenation reduces inflammation and increases the activity of cells, notably all the builder cells that perform repairs and build new tissue. It is a great cycle because HBOT not only helps the wound heal faster, it also triggers body starts making more blood vessels to deliver more materials.

In the case of wounds that are infected — such as with gas gangrene — or otherwise experiencing slow healing, HBOT acts directly on anaerobic bacteria, killing or disabling them. It also enhances immune system response by enhancing leukocyte (white blood cell) and macrophage activity. To top it off, HBOT increases the efficacy of antibiotics. All of this together heals any infection present and keeps the wound clear of invaders so the body can do its work.

No matter the stage, status, or site of healing, HBOT can help. Some patients see a great outcome after only 10-20 sessions, but 40-60 is typical depending on what point in healing the wound is at. Wounds that, by their nature, have poor blood flow and oxygenation will especially benefit: burns, radiation injuries, skin grafts, ulcers, gangrene, and gas gangrene.

Resources

https://www.ncbi.nlm.nih.gov/pubmed/26774522