Is it true that CMS does not cover Chronic Proctitis d/t Late Effects of Radiation because it is a muscle and not a soft tissue?
I am hoping to get some information on healing rates post MOHS procedures when patients are referred to a wound clinic versus the wound being managed by dermatology. Any published articles or data wou...
Hello we have a patient diagnosed with Buerger's disease. Would this qualify the patient for HBO under Arterial insufficiency?
Thank you in advance.
Can a compression dressing/wrap (ACE Wrap, 2 Layer, 4 Layer) be worn or kept on while using a Lymphedema Pump? Our service rep for the company we use to order Lymphedema Pumps states it is safe to lea...
Hi, just a safety HBO question. We have a patient being evaluated for HBO for ORN, with CT findings of mild bronchiectisis and bronchiolectisis. No blebs and assuming pulmonary function tests are not ...
Our Chief Medical Officer has asked me to provide "some scholarly/clinical articles about the clinical improvements noted with ABI information." Does anyone have anything that would satisfy this requ...
I just finished a new formulary for my hospital and was wondering if anyone knew of or has a basic dressing selection algorithm that I can use as a guidance for physicians and nurses that that can be ...
Hello! Is there a certain timeframe to wait after a pt has cataract surgery prior to starting HBO?
Hello I was reading the Evidence-based indications accepted by the UHMS and Medicare, and it mentioned < 4,000cGy of radiation. If one is unable to obtain radiation treatment notes does this not qual...
Hello,
This might be a silly question. I tried to research it, but when using an alginate dressing a superficial wound do you cut to fit or overlap? If it is draining large amounts I cannot imagin...
I am attempting to create a MDRPI prevention/management protocol for the hospitals that I manage. Is there anyway that I can receive guidance on creating an EBP protocol for MDRPI prevention/managemen...
Hello,
For small wounds that require a wound vac and have a tunnel, what is the best method for foam application? Is it best to not pack the tunnel if it is not deep or pack with white foam and bla...
Can a patient go into the hyperbaric chamber safely with a Dexcom sensor pad left in place?
I have a DM patient with an ulcer to the bone at the lateral malleolus level. Can I use the Wagner classification system? (Or does the ankle not count). I would like to do HBO on this patient. Than...
Hi,
I just have a general question regarding CMS guidelines for using the Marx protocol 20:10 for dental tooth extraction for a high risk patient, under the diagnosis of STRN. Has there been any issu...
Hello
I have a patient that has a severe case of Hidradenitis suppurativa along with Psoriasis. In 4/2021 he had a case of Fournier's gangrene that was surgically treated and closed with a wound vac...
Hello,
We have an HBO candidate (ORN)
Pt was taking Cis-Platin and Bleomycin
Both were D/C in February of 2021
Also pt has a lesion in mouth that they suspect is cancer, (it is at the same i...
Hello, we have a new pt referral for osteo, but he has an implanted BioMonitor 2 AF. All BIOTRONIK CRM devices are not recommended for HBO due to the potential for damage or impaired function of the...
We have a patient with a history of squamous cell carcinoma of the right head and neck who completed radiation therapy on 10/15/2021. She presented to otolaryngology with three week history of pain ...
We have a new referral for hyperbaric treatments (necrosis of bone and soft radiation) with history of SCC of scalp with two large open wounds. One wound measures 15x13x0.3 cm with 5.3x5.5 cm of expo...
We have a patient who has been receiving HBO in a monoplace chamber. The wound was not showing progress, so Podiatrist took into surgery and debrided the involved bone and resected the cuboid. She pla...
I saw a patient today with pyoderma gangrenosum for a Palliative Care consult. She has a very rare presentation of occasionally having mucosal lesions that are located in her throat that are quite pai...
What is the role of pentoxifylline (Trental) in venous stasis ulcers? Wound Reference is recommending 400 mg TID in addition to compression therapy to promote ulcer healing. Is it commonly used in w...
76-year-old female does wound has a duration of one year and six months but it has had a wound in this area that has healed prior. ABI is normal she is not diabetic
The ideology of this wound has ...
I need treatment suggestions for wound
Patient referral for HBO. CXR done for workup for HBO identified new Dx: Emphysema. Referred out to Pulmonologist who ordered CT Chest and PFT. Question, what should FEV1 value be pre-bronchodilator a...
Hi,
We have a patient who underwent and completed a course of HBO for ORN of the jaw 3 years ago successfully. Oral surgery will need to do another tooth extraction and questioned if further HBOT wou...
12/13/21 by
Bill Khoury,
We were trying to get information with regard to use of the Libre continuous glucose monitor in the chamber. We have an expired safety bulletin from 2019 - May 2020 stating the sensor is approved up t...
Have been using Medihoney. Yellow tissue is adhered and debridement was done last week
We have an HBOT candidate with a remote history of pneumothorax after central line placement (10 years ago) and subsequent pleurodesis. Would there be any issues or increased risk with treatment in a ...
11/10/21 by
Bill Khoury,
Have there been reports of hyperbaric oxygen therapy contributing to worsening pulmonary hypertension. I had a patient earlier this year that we were treating for Wagner grade 3 diabetic foot ulcer. ...
Hi, I'm working with my orthopedic surgeon to provide wound care to a patient's hand that's now undergone 2 surgeries for a removal of an abscess that started from IV drug use. There are some sutures ...
Patient with Hx: Soft Tissue Radionecrosis (Basal Cell Carcinoma of Sternum), with partial sternectomy and omental flap, Radiation Tx 6/2/20 - 7/20/20 (total 33 txs). Started HBO Therapy 8/17/21. Orde...
Does anyone have any experience with the MESI mTABLET ABI/TBI?
We have a patient on our list for hyperbaric treatments that has a Liva Nova annuloplasty (mitral) ring inserted in 2020 and a Atriclip LAA exclusion system also inserted in 2020. We plan on diving hi...
Wondering if anyone has used HBOT to treat calciphylaxis in addition to sodium thiosulfate and proper wound care? Also wondering if anyone has had Medicare make an exception and cover HBOT treatments...
This patient has an unstageable pressure ulcer to hip with hard, adherent eschar. What is the best treatment recommendation for the patient?
This wound began as a DFU plantar surface and erupted medially. Surgical debridement about 4 weeks ago. NPWT was applied in surgery, patient was referred to outpatient wound care 1 week post-op. No co...
Currently treating a cancer patient who smokes marijuana for pain control. We coached him not to smoke prior to treatments but I'm having trouble finding any studies or recommendations regarding safe...
We have been seeing this patient off and on for at least 3 years, she has a non-surgical fistula, mess is seen. She has been seen at Mayo and here in Newton and no surgical option has been given. At t...
What is the official definition of a diabetic foot ulcer? Is any wound on the foot of a diabetic considered a diabetic foot ulcer. I have a patient with diabetes and paraplegia with a pressure ulcer...
Question about wound I have been trying to manage:
Allergies: The patient is allergic to penicillin and sulfa drugs.
Past Medical History: Anoxic brain damage, chronic respiratory failure with...
I was wondering how long you recommend a patient take a break from HBOT after an adverse reaction. For example, if they had an oxygen toxicity seizure, but no lasting effects, when would you resume tr...
I have a patient who has confirmed venous insufficiency and GSV reflux, with normal ABIs, who has been unable to undergo surgery due to recurrent pseudomonas pneumonia and COPD exacerbations. He requi...
General question: In working with our Patient Relations Staff in the Quality Department, they have posed questions regarding how a wound is determined to be clustered. I seem to remember reviewing the...
Is NPWT contraindicated in a wound bed where osteomyelitis has been confirmed? I was thinking yes but wanted to confirm. Specifically this is for a stage 4 large sacral wound.
Is NPWT contraindicated in a wound bed where osteomyelitis has been confirmed? I was thinking yes but wanted to confirm. Specifically this is for a stage 4 large sacral wound.
Pt has had multiple ulcers over 20 years that have closed with minimal wound care. This time the wound has been open for 2 years when he presents to us. ABX and now a wound vac have been employed and ...
20 yo female has had a wound since 2019. Original injury was a laceration that developed into necrotizing fasciitis. CRP still elevated at 50. How long does the CRP remain elevated in a noncomplica...
Has anyone used Actigraft? Would you share your experience?
