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We have a lady with a radiation injury (open ulcer) on her right ankle due to skin cancer from several years ago. She is currently receiving radiation to areas on her face for cancerous lesions. No chemo for 6 months.
We're hoping a plastic surgeon will apply a skin graft at some point but we are not currently sure. Will she be treated under the STRN or LRTP protocol? She has commercial insurance. She also had very recent bilateral cataract surgery with lens implant. Would HBO effect her lens implant?
Jan 25, 2018 by Troy.Enneking, RN, CHRN
1 replies
Jeff Mize
RRT, CHT, UHMSADS
A minimum of 6 weeks between the completion of Radiation Therapy and the initiation HBO therapy is recommended. HBO provided concurrently may potentiate the adverse effects of the Radiation therapy. The patient should be treated under the STRN protocol due to persistent soft tissue/integumentary breakdown within a previously irradiated field that has failed conservative and/or surgical management. The role of hyperbaric oxygen is one of overcoming the late-radiation effects. Acute inflammatory responses to ongoing or recently completed radiation therapy need to be differentiated. Recent cataract surgery with or without lens placement is not a relative contraindication. However, the possibility of oxygen-induced myopia should be discussed with the patient, as per standard operating procedure with all hyperbaric patients.
Jan 25, 2018
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