WOUND THEARPY: OXYGEN TREATMENT IS A NEW WAY TO HEAL

When the wound from a brown recluse spider didn't heal properly, doctors knew another treatment was necessary for Francis Frelix-Vann of St. Mary, Mo.

They recommended hyperbaric oxygen treatments. After just three sessions at Southeast Missouri Hospital, Frelix-Vann already can see dramatic differences.

The area around the bite on her right thigh already has shrunk and started to blister. "I know it's healing because it's starting to itch," said the retired U.S. Army nurse.

Finding the exact cause of a chronic wound helps medical staff develop plans for fast, effective treatment.

"It's not just looking at it and saying you have a sore' but figuring out why," said Marlene Lyon, nurse manager at the Wound Healing Center at St. Francis Medical Center.

Factors like a poor diet, an infection or even a blocked artery could be the cause of slow healing for a wound. Medical staff at both hospitals first must assess each patient to determine the best treatment therapy for the wounds.

In some cases, an aggressive plan developed by a wound healing center can be all that's required. Since St. Francis' center began seeing patients a month ago, two of them have healed -- much faster than the expected 16-week time frame.

However, not all cases are like that. Some more serious wounds require intense treatment, like hyperbaric oxygen.

Supercharged cells

The oxygen treatment uses 100 percent oxygen to supercharge blood cells and blood vessels in the body to fight infection. The chambers at Southeast hospital are the first in the area. St. Francis Medical Center expects to unveil its hyperbaric oxygen chambers within the next two weeks. The medical center also has an instrument that can measure oxygen flow around a wound to see if the area is getting adequate blood supply.

Oxygen therapy is used to treat wounds that haven't healed using other methods, cyanide or carbon monoxide poisoning, serious burns, tissue diseases and crush injuries.

The treatment can help save limbs that might otherwise have to be amputated, which is the most exciting part of the therapy, said Dr. Robert Perry, medical director for the hyperbaric medicine center at Southeast hospital.

As an internist, Perry saw many older patients who suffered from foot and leg injuries related to diabetes. Often those patients faced more complications and sometimes the loss of a limb, but that could have been prevented with oxygen therapy.

The treatment at St. Francis is patient-focused, so even though someone comes for wound healing, other ailments won't be overlooked. A team of doctors -- vascular surgeons, plastic surgeons, a physical medicine specialist and a hospitalist -- are available to see patients for treatment.

"We have more of a concern for the patients rather than just what you see with the appearance of a wound," said Jim Lawrence, director at the Wound Healing Center.

But the appearance of a wound can alert doctors to its severity. Frelix-Vann's wound from the brown recluse spider isn't a wound that was going to heal by itself, Perry said. For many patients, the wounds have been present for months and there has been no change.

Developing a plan

St. Francis' wound center works with patients and their primary-care doctor to develop the best treatment plan. Patients receive pain therapy or medications and don't have to wait long periods to see a doctor, Lawrence said.

While many physicians know the importance of treating wounds, they are sometimes uneducated about the benefits of hyperbaric oxygen treatments, Perry said. Until he began studying it to become the center's director, "it was just a paragraph in a textbook."

"Everybody could qualify for hyperbaric treatment. Even simple wounds would heal with less scarring," Perry said.

But oxygen therapy isn't for every wound. Only 40 percent of the patients seen in Southeast's wound center likely will qualify for the treatment, said Mark Smith, unit coordinator. And not all insurance companies will pay for the treatment.

Much like an airplane climbs to higher atmospheric levels, Frelix-Vann "dives" to lower levels of pressure inside the chamber. She spends two hours inside the cylinder, immersed in oxygen. It takes about 15 minutes to get acclimated to the lower levels, and another 15 minutes to climb back up.

Being inside the chamber is like going up in a plane, she said. "It's like being in a cloud."

Once inside the chamber for her treatment, she uses the time to meditate. The air is sweet and clean, she said. "It's like breathing the air in Canada."