Q: Is there any good proof that extremity HBO chambers are effective?
A: All of the panelists agree that this is a highly controversial subject and emphasize that HBO extremity chambers provide an entirely different type of therapy than the monoplace chambers that provide systemic HBO.
Dr. Kominsky says the buzz on extremity HBO chambers tends to be cyclical. He recalls that approximately 15 years ago, several companies touted the benefits and safety profile of extremity HBO chambers. Around the same time, Dr. Kominsky notes there were several published reports that said the units were ineffective because they could not provide the same amount of atmospheric pressure as the full body units. He also points out that the same reports said the units were dangerous and prone to exploding.
Several new companies are again promoting the benefits of employing extremity HBO chambers, but Dr. Kominsky says he doesn’t have any experience in using these devices.
Dr. Sage has used extremity HBO chambers on two occasions with successful healing in renal transplant patients who had stubborn ulcers but otherwise adequate vascular perfusion. However, he cautions that he’s not sure whether it was the topical HBO that made the difference or whether the extra care involved motivated the patients to offload more effectively and thus facilitated healing.
Dr. Armstrong has doubts about the extremity chambers. He says systemic HBO, theoretically, works by supersaturating hemoglobin and then plasma with oxygen at greater than one atmosphere absolute. “Unless one’s legs have evolved to the point where they have sprouted gills, that cannot be the mechanism of action of topical HBO,” maintains Dr. Armstrong.
Drs. Brill and Sage add that they aren’t aware of any definitive, controlled studies that demonstrate the efficacy of topical HBO.