Oxigenoterapia Hiperbarica para ayudar con Radio Necrosis de tejidos blandos y osteoradionecrosis

¿CON QUE PUEDE AYUDAR LA CÁMARA HIPERBÁRICA EN LA RADIO NECROSIS DE TEJIDOS BLANDOS Y OSTEORADIONECROSIS?

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La terapia de oxígeno hiperbárico (TOHB) puede tener varios beneficios en el tratamiento de la radio necrosis de tejidos blandos y osteoradionecrosis, que son complicaciones potenciales de la radioterapia. A continuación, se enumeran algunos de los beneficios, usando presiones mayores a 2.0 ATA:

  1. Mejora la oxigenación de los tejidos: La TOHB implica la exposición a oxígeno puro a presiones elevadas, lo que aumenta significativamente la cantidad de oxígeno que se disuelve en la sangre y llega a los tejidos afectados. Esto promueve la oxigenación de los tejidos dañados y ayuda en el proceso de curación.

  2. Reducción de la inflamación: La TOHB puede reducir la inflamación en los tejidos afectados, lo que a su vez puede aliviar el dolor y mejorar la función.

  3. Estimulación de la formación de nuevos vasos sanguíneos: La TOHB puede promover la angiogénesis, que es la formación de nuevos vasos sanguíneos en la zona afectada. Esto puede mejorar el suministro de sangre a los tejidos y acelerar la cicatrización.

  4. Apoyo a la reparación del tejido óseo: En el caso de la osteoradionecrosis, la TOHB puede ayudar en la reparación y regeneración del tejido óseo afectado.

  5. Reducción del riesgo de infección: La TOHB crea un entorno en el que las bacterias tienen dificultades para sobrevivir, lo que puede ayudar a prevenir infecciones secundarias en los tejidos dañados.

  6. Promoción de la cicatrización de heridas: La TOHB puede acelerar el proceso de cicatrización de heridas, lo que es especialmente beneficioso en el caso de úlceras o lesiones en tejidos blandos.

LA TERAPIA HIPERBARICA EN LESIONES POR RADIACION EN TEJIDO BLANDO Y HUESO

Las lesiones por radiación se dividen en tres tipos: agudas (problemas inmediatos), subagudas (problemas que aparecen después de unos meses) y complicaciones retardadas (problemas que pueden aparecer después de un largo tiempo). A veces, las lesiones agudas nunca se resuelven y se convierten en problemas crónicos.

No entendemos completamente por qué ocurren estas lesiones después de la radiación, pero sabemos que afectan los vasos sanguíneos y pueden causar daño en los tejidos, nervios y células que ayudan con el colágeno.

El oxígeno hiperbárico es una terapia que se usa para tratar estas lesiones y esta bien estudiada por la UHMS o Undersea and Hyperbaric Medical Society. Ayuda a formar nuevos vasos sanguíneos, reduce el tejido cicatricial y puede aumentar la cantidad de células madre en el área afectada.

Una de las lesiones más comunes que se tratan con oxígeno hiperbárico es la Oste radio necrosis de mandíbula (ORN) causada por la radiación, sin embargo puede ayudar con cualquier tipo de retardo en cicatrización de tejido. En este caso, la terapia suele combinarse con cirugía y/o limpieza para ayudar con el tejido dañado.

La aplicación temprana de oxígeno hiperbárico (OHB), ya sea como medida preventiva o proactiva, puede ser beneficiosa para detener la progresión, reducir el tiempo de recuperación y el riesgo de complicaciones en lesiones causadas por radiación retardada. Es importatne comentar que para tratar estas lesiones, generalmente se necesita un enfoque que involucre a varios especialistas médicos y esta terapia.

Elder man, dogs, puppy-1281284. Jpg

¿CUANTAS SESIONES SE NECESITAN?

La cantidad de sesiones necesarias de terapia de oxígeno hiperbárico (TOHB) para el tratamiento de la radio necrosis de tejidos blandos y osteoradionecrosis puede variar según la gravedad de la afección y la respuesta individual de cada paciente. No hay un número fijo de sesiones que se aplique a todos los casos, ya que la TOHB se personaliza según las necesidades clínicas.

En general, un tratamiento típico con TOHB puede consistir en sesiones diarias o casi diarias durante varias semanas. Por ejemplo, un régimen de tratamiento podría ser de 30 a 40 sesiones, realizadas cinco días a la semana durante un período de seis a ocho semanas. Sin embargo, esto puede variar. Ejemplo, en algunos casos si vas a entrar a una intervención quirúrgica se tendría que entrar varias sesiones antes y luego despues. Algunos pacientes pueden requerir un número menor o mayor de sesiones según su respuesta al tratamiento y la evaluación de su equipo médico.

CÓMO SIRVE LA TERAPIA EN CÁMARA HIPERBÁRICA PARA AYUDAR CON EL TRATAMIENTO DE LA RADIO NECROSIS DE TEJIDOS BLANDOS Y OSTEORADIONECROSIS

Mas detallado con estudios de soporte

Liceaga, D. E. (2014). GUÍAS CLÍNICAS DE DIAGNÓSTICO Y TRATAMIENTO DEL SERVICIO DE CÁMARA HIPERBÁRICA. Ciudad de Mexico: Hospital General de Mexico.

Undersea and Hyperbaric Medical Society. (2021). Indications for Hyperbaric Oxygen Therapy. Retrieved from https://www-uhms-org.translate.goog/resources/featured-resources/hbo-indications.html?highlight=WyJpbmRpY2F0aW9ucyJd&_x_tr_sl=en&_x_tr_tl=es&_x_tr_hl=en&_x_tr_pto=wapp

Chapter 8: Delayed Radiation Injuries (Soft Tissue and Bony Necrosis) and Potential
for Future Research
John J. Feldmeier DO, FACRO, FUHM, Laurie B. Gesell MD, FACEP, FUHM
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