What is Chronic Refractory Osteomyelitis (CRO)?
Chronic refractory osteomyelitis is a persistent or reoccurring infection of bone or bone marrow that is resistant to traditional antibiotic treatments and surgical debridement. For a case of osteomyelitis to be diagnosed "chronic refractory" the patient must first be treated with proper culture-directed antibiotics and surgical debridement for at least six weeks with no remarkable improvement. Due to the relative scarcity of blood arteries in bone and the poor penetration of many antimicrobials into bone, it is difficult to treat. Patients with diabetes, IV drug abusers, and other immunocompromised persons have a higher chance of developing osteomyelitis., however, hope can be found with hyperbaric medicine.
There are approximately 50,000 hospital admissions each year due to osteomyelitis - HBOT can help reduce this figure!
Hyperbaric Treatment Of Chronic Refractory Osteomyelitis
Surgical debridement and culture-directed antibiotics are the mainstays of treatment, however, when added as an adjunct therapy, Hyperbaric Oxygen Therapy (HBOT) has shown to have great results for patients suffering from CRO. HBOT works to expedite healing in two ways: First helping to support the creation of new bone and second to provide the necessary oxygen for the dead bone to be absorbed. Osteoclasts, cells that remove dead bone, require oxygen to operate, and intermittent oxygen pressures of 30 to 40 mm Hg are required for the growth of new blood vessels, making HBOT the adjunct therapy of choice for many wound care teams. Infected bones have decreased oxygen content at levels that create an environment where the bone simply cannot heal, however when administered alongside an interprofessional team, HBOT an help improve healing and restore quality of life.
Benefits From Hyperbaric Oxygen Treatment
When HBO is added to a treatment plan for those suffering from osteomyelitis we see a wide range of benefits. Most notably:
Improved penetration of certain antibiotics
Increased bone oxygen content
Prevents certain white cells from adhering to damaged blood vessel linings
Stops new bacteria
"Helping to heal the chronic wounds associated CRO, HBO has shown to be a game changer for the healing process. "
Juan O Bravo, MD, CWSP, UHM