Lentrodt S, Lentrodt J
Hyperbare Sauerstofftherapie, Institut für Diagnostische Radiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
Mund Kiefer Gesichtschir. 2006 Jul;10(4):263-8. doi: 10.1007/s10006-006-0006-8.
Hyperbaric oxygen therapy (HBO) leads to a significant increase of oxygen supply in poorly perfused tissue. Several physiological mechanisms of this treatment modality are suitable for having a positive effect on infected large autologous free bone transplants.
In a 49-year-old male with a metastasized squamous cell carcinoma of the floor of the mouth radical tumour surgery with subsequent radiation was performed. Nine years later an infected osteoradionecrosis of the mandible emerged which required a continuity-resection with simultaneously performed reconstruction of the mandible using an autologous free transplanted iliac bone graft. Four days post surgery wide intraoral dehiscence with complete denuding of the bone graft occurred. For this reason initiation of an adjuvant hyperbaric oxygen therapy in addition to high dose antibiotic therapy and local wound care. Combined therapy led to granulation tissue on the surface of the transplanted bone with subsequent epithelization. Complete incorporation and conversion of the bone transplant with full rehabilitation concerning function and aesthetics was noted.
Without HBO treatment the large volume infected autologous free bone transplant would have been lost. Beside other capabilities of HBO the induction of rapid neovascularisation and increasing oxygen diffusion radius are the reasons that the infected transplant was saved. Only under these conditions it was possible to erradicate the bacterial infection effectively with antibiotics.
高压氧疗法（HBO）可使灌注不良组织中的氧气供应显著增加。这种治疗方式的几种生理机制适合对感染的大型自体游离骨移植产生积极影响。
一名49岁男性，患有口底转移性鳞状细胞癌，接受了根治性肿瘤手术并随后进行了放疗。九年后，出现了下颌骨放射性骨坏死感染，需要进行连续性切除，同时使用自体游离髂骨移植重建下颌骨。术后四天，口腔内出现广泛裂开，骨移植完全暴露。因此，除了高剂量抗生素治疗和局部伤口护理外，还开始了辅助高压氧治疗。联合治疗导致移植骨表面形成肉芽组织，随后上皮化。观察到骨移植完全融合并转化，功能和美学完全恢复。
如果不进行HBO治疗，大量感染的自体游离骨移植将会失败。除了HBO的其他能力外，快速诱导新血管形成和增加氧扩散半径是感染移植得以挽救的原因。只有在这些条件下，才有可能用抗生素有效根除细菌感染。
