What is Chronic Refractory Osteomyelitis?
Infections in bone are hard to treat because there are not a lot of blood vessels in bone. Antibiotics have a hard time penetrating bone. Chronic refractory osteomyelitis (CROM) is a bone infection that has not responded to conventional therapy such as antimicrobials and surgical debridement after a 6-week course of therapy.
These chronic bone infections can occur in pediatric patients as well as adult patients, although they are often associated with other local or systemic problems. Patients who are immunosuppressed or have other co-morbidities such as diabetes, are more likely to develop CROM.
Treating Bone Infections with Hyperbaric Oxygen Therapy
In some instances, where the bone infection has a very high morbidity and mortality such as spine, skull or sternum, osteomyelitis which is not responding to treatment earlier than six weeks may benefit from adjunctive hyperbaric oxygen therapy. The most common presentation for CROM is in long bones after trauma, and in diabetic foot ulcers (DFU). In the DFU, about 20% of patients that are referred to a wound center will have osteomyelitis. If they do not respond to a course of conventional care, which includes antimicrobial therapy and surgical debridement if possible, then patients should be referred for adjunctive hyperbaric oxygen therapy, as part of a multi-disciplinary approach.
Research & Studies
- Role of hyperbaric oxygen therapy in the treatment of bacterial spinal osteomyelitis.
- Hyperbaric oxygen therapy in the treatment of chronic refractory osteomyelitis: a preliminary report.
- Oxygen tensions and infections: modulation of microbial growth, activity of antimicrobial agents, and immunologic responses.
- Results of chronic osteomyelitis of the femur treated with hyperbaric oxygen: a preliminary report
The Healing Power of Hyperbaric Medicine
HBOT helps white blood cells kill bacteria, and help osteoclast clean up the dead and infected bone. Once the infection is under control and all the dead bone is gone, new bone is laid down by osteoclasts. These processes require high levels of oxygen to function optimally. HBOT also helps antibiotics work better, and in conjunction with some antibiotics, helps eradicate the biofilms that form in many of these cases.
Increases White Blood Cell Effectiveness
Stimulates Release of Stem Cells
Improves Quality of Life in Patients
Most Conditions Covered by Insurance
How Long Does a Hyperbaric Treatment Take?
Most HBOT treatments generally take about 2 hours. Treatments for some indications can last up to 4 hours. Serious diving injuries can require a treatment for longer than 5 hours. The hyperbaric physician will determine how long each patient’s HBOT treatment will last.
Does Insurance Cover Hyperbaric Treatments?
Coverage for HBO is dependent on your insurance company’s Coverage Determination Policy.
Some indications are still not covered or coverage can vary by insurance provider. Contact us to verify coverage.