Georgetown University School of Medicine, Washington, District of Columbia, US.
Center for Wound Healing and Hyperbaric Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia, US.
J Wound Care. 2021 Sep 1;30(Sup9):S24-S28. doi: 10.12968/jowc.2021.30.Sup9.S24.
Hyperbaric oxygen therapy (HBOT) is a useful adjunctive treatment for selected complicated wounds, including severe diabetic lower extremity ulcerations and compromised skin grafts or flaps. The Sars-CoV-2 (COVID-19) pandemic has disrupted healthcare delivery, with its effects extending to delivery of HBOT. During the pandemic, paediatric patients in our geographic region who were referred for HBOT faced challenges as centres temporarily closed or were unprepared to treat younger patients. Our monoplace HBOT centre modified existing practices to allow for treatment of these patients. This study aims to outline the steps necessary to adapting a pre-existing HBOT centre for the safe treatment of paediatric patients.
A retrospective review was performed to identify patients 18 years of age or younger referred for HBOT during 2020. Patient characteristics, referral indications and HBOT complications were collected. Changes implemented to the HBOT centre to accommodate the treatment of paediatric patients were documented.
A total of seven paediatric patients were evaluated for HBOT and six were treated. The mean patient age was four years (range: 1-11 years). Referral diagnoses included sudden sensorineural hearing loss, skin flap or graft compromise, and radiation-induced soft tissue necrosis. All patients tolerated HBOT treatment in monoplace chambers without significant complications noted. Enhancements made to our clinical practice to facilitate the safe and effective treatment of paediatric patients included ensuring the availability of acceptable garments for paediatric patients, maintaining uninterrupted patient grounding (in relation to fire safety), and enhancing social support for anxiety reduction.
The results of our review show that paediatric patients can be safely treated within the monoplace hyperbaric environment.
高压氧治疗（HBOT）是一种对选定的复杂伤口有效的辅助治疗方法，包括严重的糖尿病下肢溃疡和受损的皮肤移植物或皮瓣。Sars-CoV-2（COVID-19）大流行扰乱了医疗保健的提供，其影响延伸到 HBOT 的提供。在大流行期间，我们所在地区的儿科患者转介接受 HBOT 治疗时面临挑战，因为中心暂时关闭或准备不足，无法治疗年轻患者。我们的单舱 HBOT 中心修改了现有的做法，以允许治疗这些患者。本研究旨在概述为安全治疗儿科患者而对现有 HBOT 中心进行改造所需的步骤。
对 2020 年期间转介接受 HBOT 的 18 岁或以下的患者进行回顾性分析。收集患者特征、转介指征和 HBOT 并发症。记录为适应治疗儿科患者而对 HBOT 中心进行的更改。
共有 7 名儿科患者接受了 HBOT 评估，其中 6 名接受了治疗。患者平均年龄为 4 岁（范围：1-11 岁）。转诊诊断包括突发性感觉神经性听力损失、皮瓣或移植物受损以及放射性软组织坏死。所有患者在单舱室内均耐受 HBOT 治疗，未观察到明显并发症。为了安全有效地治疗儿科患者，我们对临床实践进行了改进，包括确保有适合儿科患者的可接受服装、保持不间断的患者接地（与消防安全有关）以及加强社会支持以减轻焦虑。
我们的审查结果表明，儿科患者可以在单舱高压环境中安全治疗。
