Hyperbaric Oxygen in Acute Ischemia and Crush Injury

Tra~mSl may produce a very important tissular destruction with severe problems at bones, muscles and, of course, acute insufficiency both arterial and venous, of parts of a limb or of an entire limb. In all patients with so severe trauma, the blood supply to the crushed area is compromised and the survival of the limb is not guaranteed. So, in the treatment of a limb injury, priority should be given to the restoration of circulation. Surgical repair is of course usually required. The survival of a limb depends on anatomical reconstruction of torn blood vessels and on the period of time between injury and repair. The time limit of reimplantation at room temperature commonly accepted is'5 to 6 hours and the twelfth hour may be the point of irreversibi!ity : anoxia and ischemia are severe and gangrene may develop despite apparently successful restoration of circulation. RBO can be helpful in reconstructive vascular surgery, in maintening the li~b alive while awaiting definitive surgery (ischemic limb and muscle can be salvaged even after as long as 36 hours) or in supporting the limb immediately post-surgery until arterial blood flow improves.