BROOKINGS — In a best-case scenario, the human body has a remarkable natural ability to heal itself following medical or surgical treatment. When the body can’t do that, the Brookings Health System Wound Center, which opened in April 2021, can provide hyperbaric oxygen therapy during which a patient breathes 100 percent pure oxygen while in a pressurized hyperbaric chamber.

Reghan Boldt, BHS Wound Care Program director, cited a variety of wounds that respond to HBO therapy, including: diabetic foot ulcers; osteomyelitis, a type of deep bone infection; crush injuries, from a fall or from being pinned between two objects or by a heavy object; thermal burns; and soft tissue radiation damage.

“Any sort of radiation that has caused damage of any sort,” she explained more fully. “Often we’ll see patients with radiation to the head and neck. They might experience dry mouth, some swallowing inability, difficulty with speech. Their teeth might start crumbling; the radiation has done its job but it kills healthy tissue and bad tissue. It might decrease the amount of blood flow to the teeth and then the teeth might start crumbling. Sometimes the residual damage from radiation treatment might not manifest itself for months or even years.”

Boldt does have a couple of caveats for to those who might — with their physician, who must prescribe it — be considering HBO therapy: “This is adjunctive treatment. Typically patients have received other treatments before we offer this.”

A second caveat involves the time element for a treatment regimen that is an outpatient procedure: “The really important thing about HBO therapy is making sure you’re committed to five days a week. If you kind of jump around, it doesn’t work as well. That is something we do go through with all of our patients — the importance of committing.”

The total time demand for a complete treatment regimen — from start to finish — can be as long as 2 to 2 ½ hours per session, five days a week for about four to six weeks. More complicated demands for HBO therapy — as an inpatient — would be referred elsewhere.

Comprehensive approach

Boldt explained in simple terms, and “in a nutshell,” how each HBO therapy session in the chamber works for the patient: “In the regular air we breathe, we have 20.9 percent oxygen; I believe the rest is a mixture of other things. When you go into the chamber, you are delivered 100 percent oxygen under pressure. … What that does is rebuild tiny little capillaries that will heal a wound — typically. I don’t want you thinking it’s just for wounds, because (HBO therapy) can be used for a variety of things.” Note those various conditions cited above.

“It takes the pressure with the oxygen to help the body deliver higher amounts of oxygen to areas that would normally not receive that without pressure and without an increased amount of oxygen,” the director added. “Think of when you breathe in the air normally, it goes throughout our bodies and gets diluted. When you are put under pressure and delivered significantly more amounts of oxygen, then you have oxygen that can go farther because there is more of it.”

The two Wound Center chambers operate on a busy schedule. The actual time of treatment begins as the pressure within the chamber is increased on an individual basis. It make take anywhere from 10 to 15 minutes. While inside the chamber, the patient is breathing 100 percent oxygen. Total time inside the chamber can range from 110 to 140 minutes. So the total time — from when the patient checks in to the time they leave at the end of treatment can be from 2 to 2 ½ hours.

The patient’s safety is upfront in all that takes place and a technician is present at all times as the treatment proceeds from start to finish.

Boldt noted that the two chambers are busy five days a week: “When we’re full, we’ll do four total sessions in a day: two in the morning and two in the afternoon.”

The director has been with the Wound Care Program and team since September 2022. By way of background, in addition to her qualifications in hyperbaric oxygen therapy, Boldt has a master’s of business administration and a master’s of occupational therapy and is a registered and licensed occupational therapist and a certified lymphedema therapist.

Individualized plans

The Wound Center provides detailed information about HBO therapy to both referring physicians and patients. The “clinical model” advises physicians that the center “provides a comprehensive medical approach to treating non-healing and diabetic wounds”… “serves as an adjunct to your private practice treating patients suffering from chronic, non-healing wounds.” The center notes that “an interdisciplinary, physician-led treatment team” will assess the patient and “develop an individualized treatment plan.” The center’s goal “is to achieve desired clinical results in the shortest period of time possible, enabling patients to obtain a higher quality of life and realize a high level of patient satisfaction.”

The center advises the patient on all aspects of the “HBO therapy process,” noting that it “can save the lives and limbs of patients with wounds that are difficult to heal because of chronic medical conditions such as diabetes” and explains “how to prepare for treatment” and also addresses “the benefits of hyperbaric oxygen therapy.”

As to the success of therapy process, the patient’s role is told — in bold letters: “Your compliance with the plan of care is the single most important factor in your healing!”

Contact John Kubal at jkubal@brookingsregister.com.