Hyperbaric treatment in wound care center enhances treatment



Stan Bialoski, wound care nurse, left, Royce Read, M.D., director of Memorial Health System’s hyperbaric wound care center, and Tim McCarty, hyperbaric/respiratory therapist, right, monitor a patient in the hyperbaric chamber.



Diabetics over the age of 60 make up more than half of the patients using the wound care center and hyperbaric chamber at Memorial Health System of East Texas.  However, Medicare does not provide coverage for the hyperbaric treatment of diabetic wounds in the lower extremities, yet.


In determining whether to provide insurance coverage for hyperbaric treatment for diabetics, Medicare officials are evaluating how certain types of diabetic wounds, especially those in the lower extremities, benefit from hyperbaric oxygen treatment. Wound care nurse Stan Bialoski, hyperbaric/respiratory therapist Tim mccarty and Royce Read, M.D., director of Memorial’s Hyperbaric Wound Care Center , are waiting to see if Medicare will choose to provide insurance coverage for the treatment.  Legislators are expected to make a decision during a meeting in late July.


Hyperbaric Oxygen is a mode of therapy in which the patient breathes 100 percent oxygen at pressures greater than normal atmospheric pressure. According to Bialoski and mccarty, when a patient breathes the 100 percent oxygen under pressure, greater amounts of oxygen are dissolved in the bloodstream and carried to body tissues in amounts sufficient to promote a healing effect.


Dr. Read said diabetics often suffer from poor circulation and nerve damage, both of which can cause a loss of sensation in the feet. “They may step on something and get a cut and not know it,” he said. “The cuts can turn into ulcers and need treatment.” That’s where the hyperbaric chamber is needed.


Working in the only hospital-based, certified hyperbaric oxygen chamber between Tyler and Conroe , the hospital officials know first hand the need for these services among diabetics as well as many others suffering with wounds that will not heal.


“Diabetics are our largest patient base,” Mccarty said. “Medicare is just now realizing the benefits of saving someone’s leg or foot rather than putting a patient through surgery and then fitting them for a prosthesis. Plus there are the ensuing costs of replacement of the prosthesis over the years.”


In the six years Memorial has offered treatment in the hyperbaric chamber, more than 2,500 treatments have been provided. That number does not include the patients who come to the center for wound treatment and do not use the hyperbaric chamber. On average, four patients a day are treated in the chamber, five outpatients per day receive treatment other than in the chamber, and Bialoski usually visits 15 patients in their hospital room daily to provide wound care. On average, a patient receives 30 treatments in the chamber with each lasting about an hour and a half.


Patients must receive treatments five days per week for the length of the regime, and it’s a program that cannot be broken, Bialoski said. A patient can watch TV or even sleep while in the clear chamber. During some parts of the treatment, a patient may feel a sensation of fullness in their ears, similar to what is experienced during flying.


Prior to treatment, patients are taught several easy methods to avoid ear discomfort. Patients are monitored very closely while in the chamber, and the improvement in their overall health and wellbeing is part of the treatment, Bialoski said.


Patients can not wear hair spray or fingernail polish into the chamber. Dr. Read said patients also are required to: remove all jewelry and hearing aids; wear the hospital’s 100-percent cotton gown and they cannot take a book or magazine into the chamber.


“However, we can lay a patient’s book or magazine on top of the glass chamber and let them read through the chamber wall,” Dr. Read said. “We will turn the pages for them. Safety for the patients is a top priority, Dr. Read said, adding the staff has had extensive training and have had to pass national exams to achieve the level of Certified


Hyperbaric Technologist. Diabetics need to be sure their sugar levels are correct or the treatment will not be as effective. Also, smoking and drinking alcohol while taking these treatments can interfere with healing, Dr. Read said.


In addition to treating diabetic patients, hyperbaric oxygen is used to treat many other maladies, among those being skin damaged during radiation treatment for cancer or a skin graft that is not healing well. The treatment also is used to vastly improve success during reattachment of a severed extremity, such as a finger, Dr. Read said. “It is the gold standard course of treatment for people who have been poisoned by carbon monoxide. Often during carbon monoxide poisoning, hyperbaric oxygen means the difference between life and death.”