Testimonial

Delayed Wound Response

"A series of car accidents impacting into my knees resulted in ongoing problems with both of my legs and knees. Repeated wound breakdown, extremely sensitive skin breakdown, infected ulcers and extensive swelling in both legs - I was told that I had significant vascular compromise.

These problems were as a direct consequence of the injuries to my knees during my accidents. My right knee had multiple operations eventually requiring total replacement. My legs had been immobilized and heavily bandaged for several years because of the constant wound breakdown, skin seepage and poor circulation.

In fact, it was my general practitioner that had to change my bandages on a daily basis. When I was eventually referred by my Orthopedic Surgeon for Hyperbaric, I was unable to walk without the assistance of a walking stick and often required crutches. My Ortho. informed me that this was my last chance and I may end up with an amputation. That was then!"

Ms. RB aged 40 has a complex history of lower limb injury. Robyn’s original injury occurred during 1982 as a result of a head on motor vehicle accident. She was in the front seat passenger’s side and received injury to her right knee with a compound wound over the patella.

She also received injuries to her left foot and chest with extensive soft tissue bruising and damage to her neck and lower back. Prior to her accident she was a highly competitive marathon runner.

Robyn required plastic surgery to close the wound over her knee but continued to suffer knee and lower limb problems. Eventually arthroscopy followed by open surgery to the right knee was performed one-year later. She maintained a reasonable recovery and in fact was able to resume selective general sports and some running activity. Whilst playing a social game of squash she tore her left Achilles tendon which again significantly reduced her activities.

During May 1989 whilst driving her car was involved in another accident, this time she was hit from the driver’s side further injuring her knee, which was smashed up against the car dash. She also suffered extensive strain to her neck and lower back. She was medically examined and immediately fitted with a cervical collar and received intensive physiotherapy to her spine. She also received a course of epidural and cortisone injections into her lower back to reduce both her neck and lower back spasms.

During this same period she began developing circulatory problems involving her right leg. Shortly after her second accident she suffered a third accident further complicating her spine and legs. Her right knee continued to deteriorate and finally she received surface debridement of the joint with little success followed by patellectomy one-year later. She was told that her right knee was ‘pulped’ because of the accidents.

Robyn continued to suffer problems with her legs, suffering extensive pains, limited mobility and considerable swelling of the legs. She was referred to various vascular surgeons for opinion and recommendation. Her condition had further complicated, wound breakdown, skin breakdown, infected ulcers and extensive swelling in both legs indicating significant vascular compromise. She received a total right knee replacement during 1998 and also arthroscopy to her left knee for continued problems. Her right leg, by this stage had been constantly immobilized in a full leg elastoplast bandage due to circulatory dysfunction and wound breakdown. Her general practitioner changed her bandages daily. When bandages were removed they were generally wet and coated with a serous discharge. She was unable to walk without the assistance of aids. She had been informed that if her legs continue to deteriorate she might require above knee amputation.

Robyn’s condition in fact continued to deteriorate and as a last resort Hyperbaric Oxygenation was recommended. Investigations and clinical assessment have included spinal MRI confirming spinal degenerative joint disease and laboratory investigations including DNA PCR detection screen for Mycoplasma and Rickettsia. She tested positive to mycoplasma however species differentiation was not performed. Mycoplasma involvement is a known opportunistic infection that can negatively impact with synovial joint degeneration and wound breakdown (Nicolson 2000).

Treatment has included initially daily 90-minute HBOT sessions, antibiotic therapy and supportive physical therapy including high frequency electrical acupuncture into the lower extremities.

Robyn has improved dramatically. She no longer requires full leg elastoplast bandage supports. Her skin is no longer a ‘grayish-white’ appearance suffering constant breakdown. Her skin colour and tone has improved dramatically. She states that her skin now longer spontaneously breaks down and she does not bruise as easily, as she had grown accustomed Circulatory function and lymph drainage has improved enormously, her legs are no longer swollen and muscle structure is now evident and no longer flaccid in appearance. She no longer complains of pain associated with her treatments including high frequency electrical acupuncture to her lower limbs. Her spine has also improved. She no longer suffers acute spasms that required her to receive epidural and cortisone injections.

Overall her appearance has also improved tremendously. She reports hair that is now growing on her legs, which she states, had ceased many years ago. She has improved mobility, does not require the use of walking aids and reports a significant increase in her lifestyle and social activities.