The Experience of Hyperbaric Oxygen Therapy in Earthquake-Related Crush Injuries: Could Be Beneficial Even with Delay in Initiation.

BACKGROUND

Two significant earthquakes struck southeastern Turkey on February 6. The study aimed to evaluate the effect of HBO₂ on patients with crush injuries who received therapy at the Akyurt Hyperbaric Oxygen Therapy Center following the earthquakes.

METHODS

Thirty-three crush injury patients were included in the study. The Gustilo crush injury grading system, the Mangled Extremity Severity Score (MESS), and the five assessment host function scores were used to evaluate patients. Additionally, the duration from the time under the rubble until HBO₂ started, as well as the presence of fasciotomy/amputation before or after HBO₂, was recorded.

RESULTS

The mean duration from rescue to the initiation of HBO₂ was 195 hours. Of the patients, 63.6% were severely injured according to the MESS (≥7). The Gustilo crush injury classification distribution was 30.3% IIIC, 42.4% IIIB, and 27.3% IIIA. Before HBO₂, 87.9% of the patients had fasciotomies. Fasciotomy lines were closed (without requiring another fasciotomy or additional complications) during or immediately after HBO₂ in 72.4% of 29 patients. Following HBO₂, 78.8% of the patients did not require amputation, while 21.2% had amputations. All patients who underwent amputation after HBO₂ were in the Gustilo IIIC group and scored MESS ≥ 7. Furthermore, 71.4% of patients who had an amputation scored MESS ≥ 10.

CONCLUSIONS

Hyperbaric oxygen therapy is beneficial in limb salvage and reduces complications in crush injuries and should be included in treatment plans. In countries with active tectonic activity, appropriate planning should be implemented to ensure patients' access to HBO₂, and the number of HBO₂ centers should be increased.