Arterial Insufficiencies: Problem Wounds, Central Retinal Artery Occlusion
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Arterial insufficiencies is a broad category of conditions that are approved by the Undersea and Hyperbaric Medical Society (UHMS) for treatment with Hyperbaric Oxygen Therapy (HBOT.) The category covers:
The physiological rationale for the use of HBOT in the treatment of problem wounds is explained in the UHMS Enhancement of Healing in Problem Wounds page. These scientifically established effects of HBOT include:
In the USA, HBOT treatment for problem wounds with reimbursement from insurance companies can occur in a hospital or a private hyperbaric facility. In Canada, in order to qualify for HBOT covered by the Medical Services Plan (MSP) for problem wounds, you must have a referral to a hospital based chamber from your wound care clinic. Treatments at our facility are not covered by MSP. |
Biofilms in Problem Wounds
It has been reported by Wolcott et al. that problem wounds have a biofilm component. This is the main reason for the regular debridement of wounds in standard wound care. Physical removal of the infected surface of problem wounds is one of the only effective ways to remove the biofilm infection. Biofilm is a multi-kingdom form that bacteria can take in the body, that are strongly antibiotic and immune resistant. It is believed that the chronicity of many infections can be attributed to this bacterial form. HBOT has been shown to be a effective potentiator of antibiotics in many biofilm infections, it remains to be seen if HBOT has a direct anti-biofilm effect. For more information visit our biofilm page.
How can Oceanside Hyperbaric Help with Problem Wounds?
Early Intervention
HBOT is indicated by the medical system to enhance healing of problem wounds. This means, that in order to qualify for treatment that is covered by insurance providers a wound must not respond to 8-weeks of standard wound care. At this point, HBOT is the treatment of last resort before amputation. But why wait until the wound progresses to this point? Would it not be sensible and cost effective to enhance the healing of a problem wound before the end stage? This approach to the treatment of problem wounds requires an educated and empowered patient.
Peripheral Neuropathy and Peripheral Artery Disease (PAD) are early signs of the loss of adequate blood supply to the extremities. Sometimes these conditions can be halted or reversed with lifestyle interventions, like improved diet, exercise and weight loss. Early intervention at this point with HBOT can prevent to development of problem wounds altogether.
Cost Effectiveness
The cost effectiveness of a preserved limb through administration of HBOT versus the cost of amputation through failed standard wound care treatment is well established. This does not take into account any value for the quality of life that is sacrificed with the loss of a limb, which is priceless to the client. Nor does it consider that often amputations fail to heal and require further amputations.
The cost to the medical system and insurance providers for a hospital based hyperbaric treatment is between $1000-2000 per session. We provide the service for less than 10% of the cost.
Other Problem Wounds
The UHMS only approves 2-types of problem wounds for reimbursement. There is a growing body of evidence that shows that the same treatment protocol used for UHMS approved problem wounds is effective in the treatment of non-UHMS approved problem wounds such as:
Travel and Accommodation Costs
For local clients, the prospect of travelling to Vancouver for hospital based treatment can be cost prohibitive. The Medical Services Plan does have a Travel Assistance Program (TAP) however meals, accommodation, mileage, fuel, parking and local transportation expenses are the responsibility of the client. There is also great value in staying close to home.
For clients who are out of town or out of country, it may be cost effective to pay for travel, accommodation and treatment at our facility rather than other options. See our Accommodations section for more info.
HBOT is indicated by the medical system to enhance healing of problem wounds. This means, that in order to qualify for treatment that is covered by insurance providers a wound must not respond to 8-weeks of standard wound care. At this point, HBOT is the treatment of last resort before amputation. But why wait until the wound progresses to this point? Would it not be sensible and cost effective to enhance the healing of a problem wound before the end stage? This approach to the treatment of problem wounds requires an educated and empowered patient.
Peripheral Neuropathy and Peripheral Artery Disease (PAD) are early signs of the loss of adequate blood supply to the extremities. Sometimes these conditions can be halted or reversed with lifestyle interventions, like improved diet, exercise and weight loss. Early intervention at this point with HBOT can prevent to development of problem wounds altogether.
Cost Effectiveness
The cost effectiveness of a preserved limb through administration of HBOT versus the cost of amputation through failed standard wound care treatment is well established. This does not take into account any value for the quality of life that is sacrificed with the loss of a limb, which is priceless to the client. Nor does it consider that often amputations fail to heal and require further amputations.
The cost to the medical system and insurance providers for a hospital based hyperbaric treatment is between $1000-2000 per session. We provide the service for less than 10% of the cost.
Other Problem Wounds
The UHMS only approves 2-types of problem wounds for reimbursement. There is a growing body of evidence that shows that the same treatment protocol used for UHMS approved problem wounds is effective in the treatment of non-UHMS approved problem wounds such as:
- Venous Stasis Ulcers
- Pressure Ulcers / Decubitus Ulcers
- Calciphylaxis related wounds
- Scleroderma related wounds
- Livedoid Vasculopathy / Atrophie Blanche
- Wegener's Granulomatosis / Granulomatosis with Polyangiitis related wounds
- more soon...
Travel and Accommodation Costs
For local clients, the prospect of travelling to Vancouver for hospital based treatment can be cost prohibitive. The Medical Services Plan does have a Travel Assistance Program (TAP) however meals, accommodation, mileage, fuel, parking and local transportation expenses are the responsibility of the client. There is also great value in staying close to home.
For clients who are out of town or out of country, it may be cost effective to pay for travel, accommodation and treatment at our facility rather than other options. See our Accommodations section for more info.
How can Oceanside Hyperbaric Help with Central Retinal Artery Occlusion ?
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Central Retinal Artery Occlusion (CRAO) is a stroke of the eye. The physiological rationale for the administration of HBOT in CRAO is covered in the UHMS Arterial Inefficiencies: Central Retinal Artery Occlusion Page.
One of the key factors in the success of HBOT in the treatment of CRAO is the timeliness of administration. Unfortunately, for local clients and referring physicians prompt treatment in a hospital setting is not possible, as the Vancouver Island Health Authority (VIHA) has no hyperbaric chambers. The only option for prompt hyperbaric care for Vancouver Islanders is referral to a private facility like Oceanside Hyperbaric. The effectiveness of HBOT on chronic CRAO is unknown, so late treatment of CRAO would be experimental._ |
Allied Local Diabetic Foot Care Providers
Ambulatory Care Clinic
Oceanside Health Centre 250-951-9500 Requires completed enrollment form (also see FAQ) Oceanside_Health_Centre@viha.ca |
Katia Langton, CPed
Island Pedorthic Footcare - Certified Pedorthist 250-758-1716 islandpedorthicfootcare@gmail.com |