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Information/Education Rep
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Putting the pressure on crush injury: hyperbaric therapy, wound care and the management of a crush injury First Author: Patricia Bregar Authors: Brenda Leon, RN, Cynthia Thayer, CHT, Linda Deas, RN Clinical Problem: A 76 year-old diabetic female presented to the clinic three days after dropping a toolbox on her right foot. The crush injury resulted in an 8.2 cm x 5.2cm blister to the dorsum of her right foot. Radiographs revealed no bony injury. Approach: The treatment plan included hyerbaric therapy at 2.5 atmospheres for ninety minutes daily for twelve treatments, silver hydrofiber to the blister and a compression wrap for edema control. Oral antibiotics and pain medication were prescribed. Upon completion of hyperbaric therapy, therapeutic ultrasound was ordered to assist in reducing the edema and hematoma. Sharp debridement was performed to removed devitalized tissue on week eight and ten. On week eight, the primary dressing was changed to a silver hydrogel. On week ten, the patient reported the silver hydrogel caused pain and burning so plain hydrogel was ordered. Outcome: The patient healed after seventeen weeks of treatment. Conclusion: Hyperbaric oxygen therapy, in conjunction with therapeutic ultrasound and appropriate wound care, was effective in the treatment of a crush injury. |
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