The diving tank that can heal leg ulcers… and it may help with migraines, too
01:12 GMT, 27 November 2012
Hyperbaric medicine is being used for other conditions, including migraine
When Gwynneth Flowers tripped in her kitchen and cut her right leg she barely gave it a second thought. The wound was only a few centimetres long, so, after receiving a couple of stitches, she thought that would be that.
However, two weeks later she developed an infection and was diagnosed with necrotising fasciitis — a rapidly spreading infection that eats away at the connective tissue of the skin.
Within days, what started as three small blisters on her toes had turned into an open sore that spread halfway up her thigh.
Gwynneth, 75, spent two weeks in intensive care and a further six weeks in hospital on a ward.
As well as undergoing five procedures to remove dead skin, she needed a skin graft taken from her left leg to replace the dead tissue. A year on, her leg had still refused to heal and doctors dropped the bombshell that they thought it should be amputated.
‘It was so frustrating that this small cut should end up having such a major impact on my life,’ says Gwynneth.
‘It wept constantly — I would put a clean dressing on it and an hour later it would be soaked; at night I had to put towels on the bed.
‘It didn’t hurt as such, but it impacted on my mobility because I had an open wound that leaked, so it made me nervous and made it hard to walk,’ says Gwynneth, who lives in Kensington, West London, though travels around the country for her job as a management consultant.
‘The doctor suggested I have the leg removed because I was getting infections in it all the time and was at risk of getting necrotising fasciitis again — and if this happened then it could be life-threatening.
‘My son, who is a surgeon, said it was not such a bad idea, but I didn’t want to lose my leg,’ she says. ‘I still work and value my independence, and wanted to be able to get around as normal.’
However, Gwynneth managed to avoid this drastic action and is now enjoying good health. Her secret Hyperbaric oxygen therapy.
This is a treatment normally used to help divers who have risen to the surface too quickly. This causes bubbles of nitrogen to form that can then travel around the body, to places such as the joints or lungs where they cause pain or breathlessness — a condition known as the bends.
To counter this, divers are put in a chamber into which oxygen is pumped at ten times higher concentration than normal.
Increasingly, hyperbaric medicine, as it is known, is being used for other conditions, including migraine — a review of nine trials involving 201 people carried out by the respected Cochrane Library in 2008 concluded that it’s an effective treatment.
It has also been investigated as a way to help treat stroke, with one study finding that in mice it reduced brain damage.
Last year, a study in the journal Gut concluded that hyperbaric medicine is the best current treatment for radiation-induced proctitis (a painful inflamed rectum linked to radiotherapy for abdominal cancers).
Radiotherapy for cancers in the abdomen carries the risk of damaging healthy surrounding tissue, such as in the bowel, leading to chronic pain, diarrhoea and incontinence.
A previous pilot study has shown hyperbaric medicine can help reduce inflammation. Now the Royal Marsden Hospital in London is running a trial. ‘We are looking to try to answer once and for all whether hyperbaric oxygen therapy reverses symptoms and improves quality of life,’ explains Professor John Yarnold, the oncologist leading the trial with Dr Jervoise Andreyev, a consultant gastroenterologist in pelvic radiation disease.
Hyperbaric oxygen therapy is also being used to help heal skin grafts and ulcers.
Oxygen plays a key role in the healing process — that is, if it can reach the damaged area. ‘The principle behind hyperbaric oxygen therapy is that there’s a lack of blood flow to the areas you are trying to treat,’ says Dr Oliver Firth, who is involved in the Royal Marsden trial.
Eddie Chaloner, a consultant vascular surgeon at Blackheath Hospital, South-East London, recommends the treatment to his patients when ulcers are caused by trauma.
‘These are essentially wounds that refuse to heal and are most common among older ladies as their skin tends to be thin and papery — although people who have been on steroids for a long time are also prone to them as their skin becomes thin.
‘The most common site is on the shin bone. This is because there is little tissue between the skin and the bone, so there is little blood supply in the area to aid healing.
‘The problem is that this treatment is not available all over the country as there aren’t that many hyperbaric chambers around and not all trusts will pay for the treatment.’ Indeed, the National Institute for Health and Clinical Excellence (NICE) recommends the use of hyperbaric oxygen treatment only for those with diabetic-based foot ulcers, and only then as part of a trial.
Otherwise the costs — between 150 to 200 a session — may sometimes be met by the individual, healthcare insurers or some health authorities.
Gwynneth found out about the treatment from a friend. ‘I went to see my GP who thought it was a good idea to try it and agreed to ask the local NHS Trust to pay for it, but it never replied.
‘At the same time, I wrote to NICE but it responded that it was “not aware of any benefits of hyperbaric treatment that could justify NHS funding”.
‘I took the view that there was no price to put on a leg and my independence, so I decided to pay for it myself.’
She started a course of 25 treatments in 2010 at the Oxygen Healing Clinic at the private Hospital of St John & St Elizabeth in North London (which has one of the nine or ten chambers in the UK).
She initially underwent two-hour sessions four or five times a week.
‘You had to take all metal off and change into hospital overalls, then you got into the oval-shaped chamber, which is about 10ft by 20ft — room for seven or eight people — and then they locked the door,’ she says.
‘Inside there were benches to sit on and there would be between three to five of us in there at any one time. It’s big enough so that you don’t feel claustrophobic.
‘They increase the pressure and you put on a mask and breathe in just about pure oxygen.
‘You feel a bit woozy when you come out, but otherwise it’s not unpleasant in any way.’
She says after just one week’s treatment the discharge from her leg ‘had virtually stopped’.
‘The consultant I was seeing at Charing Cross Hospital in London was amazed by the results.
‘Now it has healed up and has made a phenomenal difference to me. I can have a shower or a bath; I don’t have to wear long skirts and can get around so much easier.
‘Yes, hyperbaric is expensive. However, I’d had a year of visits from nurses to treat my wounds, clinic appointments, stays in hospital — how much was all that costing the NHS Far more than the few thousand pounds my hyperbaric treatment cost me.
‘I like my leg and I am very glad I still have it!’