After 14 Treatments

Plastic Surgery

Better Resultsfor Plastic &Reconstructive

Surgery Patients

Hyperbaric Therapy

Heal Up To 80%Faster

John H. Hartley, Jr., MD, FACS, hasbeen using a hyperbaric chamber in hisoffice on surgery patients sinceSeptember 2002.

The Hyperbaric Therapy Center104 Colony Park Drive, Ste. 800

Cumming, GA 30040678-513-1200

The effect of hyperbaric oxygenation on theviability of human fat injected into nudemice.Shoshani 0; Shupak A; Ullmann Y; Ramon Y;Gilhar A; Kehat I; Peled IJ. Plastic andreconstructive surgery 2000 Nov; 106 (6), pp. 1390-6; discussion 1397-8.

"Histopathologic examination of thedissected grafts demonstrated asignificantly better integrity of the fattissue in the group that receivedhyperbaric oxygen for 5 days (p =0.047).This finding was manifested by thepresence of well-organized, intact fatcells, along with a normal appearance ofthe fibrous septa and blood vessels."

[The value of hyperbaric oxygen therapy(HBO) in treatment of problem wounds inthe area of plastic-reconstructive head andneck surgery.] Der Stellenwert der hyperbarenSauerstofftherapie (HBO) in der Behandlung vonProblemwunden im Bereich der plastisch-rekonstruktiven

Kopf-Hals-Chirurgie. Grundmann T; Jaehne M;Fritze G. Laryngo- rhino- otologie[Laryngorhinootologie) 2000 May; 79 (5), pp. 304-10.

"The authors conclude that HBO[hyperbaric oxygen] primary clinicalapplication in treatment of problematicwound healing in head and neck appearsto be very effective and helpful andshould not be underrated whilstdiscussing this therapy in differentcontexts."

After 10 TreatmentsAfter 7 Treatments

Before Treatment

After Treatment

Polly Fritsch

Treatment Protocol

Day 1 to 10: 1 treatment per day

Day 10 to 17: 1 treatment every two days

Day 18 Thereon: 1 treatment per week

"I am extremely grateful to HyperbaricTherapy for allowing me the use of theirhyperbaric chamber. I firmly believe thatwithout the use of the hyperbaric, I wouldhave had to have skin grafts."

Hyperbaric Therapy is a NaturalAdjunct to Plastic Surgery.

Hyperbaric Therapy is not experimental nor is ita new treatment for wounds and burns. It hasbeen used in hospitals as a treatment forwounds and thermal burns since 1965.

During surgery, skin and/or cartilage may be cutand repositioned. Around these cuts there iscompromised blood flow due to the damage toblood vessels and the interruption to oxygencarrying red blood cells. Since blood carries life-giving oxygen, which is essential to the healingprocess, it is critical that these compromisedareas receive enough oxygen in order to healproperly. The swelling and edema thataccompany surgical wounds can also compressnearby vessels, further compromising blood flowand oxygen delivery to the affected cells at thewound site. Cells which are deprived of oxygenmay lie dormant and eventually die.

Oxygen is very important to wound healing.Given the appropriate conditions and with thehelp of hyperbaric therapy, viable cells fromhealthy areas migrate into wounds and start toreproduce.

Additionally, hyperbaric therapy can enhance theamount of oxygen present in the blood as wellas allow oxygen to reach the compromised areaby forcing oxygen to dissolve into the plasma.This additional oxygen can make up for some ofthe loss of blood and oxygen to thecompromised areas. The quicker oxygenrestoration occurs results in a better recovery.since early on, there are more viable cells tosalvage. The patient heals significantly faster.Therefore, the decreased healing time is likely toresult in less scar tissue around thecompromised area.

"Decreased edema (fluid] noted followinghyperbaric treatment allows better diffusionof oxygen and nutrients through tissueswhile also relieving pressure on surroundingvessels and structures."

Michael Neurmeister, MD, FRCSC, FACS

Primary Effects of HyperbaricTherapy

Hyperoxygenation• Greater oxygen carrying capacity

• Increased oxygen diffusion in tissue 'f1uid

• Diffusion distance proportional to thesquare root of dissolved oxygen

Decrease Gas Bubble Size• Boyle law - Gas volume inversely

proportional to pressure

• Hyperbaric diffusi-on gradient favors gasleaving the bubble and oxygen moving in,metabolizing oxygen in the bubble

• Bubbles become unstable as theydecrease in size

Secondary Effects of HyperbaricTherapy

Vasoconstriction• Decreased inflow into tissues

• Decreased edema

Angiogensis• Increased oxygen gradient between

wound 'and surrounding environment

• Increased fibroblast proliferation leading toincreased collagen deposition _,'andincreasedfibronectin, which aids inneovascularization

Fibroblast -Proliferation• Oxygen-dependent proliferation

Leukocyte Oxidative Killing• Increasedoxygen free radicals

• Anaerobes lack superoxide dismutase tocontrol oxygen free radicals

Toxin Inhibition• Decreased clostridial alpha toxins

Antibiotic Synergy• Fluoroquinolones, amphotericin B, and

aminoglycosides - Use oxygen to transportacross cell membranes

A Physics Lesson

In Layman's terms..• Oxygen just like any othergas behaves in accordance with the laws ofphysics. The increased pressure in a hyperbaricchamber decreases the volume of oxygen, butincreases the amount of it. Therefore, there ismore oxygen to dissolve into the plasma thanthere would be breathing 100% oxygen atnormal atmospheric conditions.

Under normal atmospherl~ conditions, thephysiological maximum, Of oxygen carried inthe blood stream bound to ,hemoglobin is97.5%. The remaining 2.5%18 dissolved inplasma. However, under hyperbaricconditions there can be up to a 400%increase in oxygen satul1Jtion.

Immune'Function.All surgeriesdepr~$ the _immune systemmaking one ,Il')0resusceptible to infection."Medical sCienQ6:!