Information for referring doctors

Consultation is provided by GHS physicians trained in hyperbaric medicine through approved courses of the AMA/Undersea Medical Society.  John Kudlak, D.O., is the medical director for Hyperbaric Services at Greenville Memorial Hospital and 
John York, M.D., at the Vascular Health Alliance.

Greenville Memorial Hospital - available for outpatient and inpatient
701 Grove Road, Greenville, SC 29605
(864) 455-8432

The Lung Center - outpatient consultation
200 Patewood Drive, Suite B300
Greenville, SC 29615
(864) 454-4200

Patewood - Vascular Health Alliance - available for outpatient
200 Patewood Drive, third floor
Greenville, SC 29615
(864) 454-2852


Patient Consultation and Referrral Procedure

To consult with a hyperbaric specialist or refer a patient, call (864) 455-8432.  Hours M-F, 7:00 a.m. - 3:30 p.m.
Emergency services are available 24/7 for the following conditions:
  • Acute carbon monoxide poisoning
  • Gas / air embolism
  • Gas gangrene
  • Cyanide poisoning
  • Necrotizing Fasciitis
For emergencies, after hours and holidays, call (864) 455-7874.

Early consultation is critical for optimal HBO, especially for potential skin graft or flap failures, crush injuries, gas gangrene and radionecrosis.

Conditions that HBO might benefit

  • Air or gas embolism
  • Carbon monoxide poisoning and smoke inhalation
  • Carbon monoxide complicated by cyanide poisoning
  • Clostridial myonecrosis (gas gangrene)
  • Crush injury, compartment syndrome, and other acute traumatic ischemias
  • Enhancement of healing in select problem wounds
  • Exceptional blood loss
  • Necrotizing soft tissue infections (subcutaneous tissue, muscle, facia)
  • Osteomyelitis (refractory)
  • Radiation tissue damage (osteoradionecrosis
  • Skin grafts and flaps
  • Thermal burns

Contraindications

Absolute

  • Untreated pneumothorax

Relative

  • Upper respiratory infections
  • Chronic Sinusitis
  • Seizure disorders
  • Emphysema with CO2 retention
  • Uncontrolled high fevers
  • History of spontaneous pneumothorax
  • History of thoracic surgery
  • History of reconstructive ear surgery
  • Viral infections
  • Congenital Spherocytosis
  • History of optic neuritis
  • Cataracts

Physiologic Effects of Hyperbaric Oxygen

The main therapeutic value of hyperbaric oxygen lies in increasing the tissue partial pressure of oxygen. An arterial oxygen pressure of 1800mm of mercury is possible when the patient breathes 100% oxygen at three Atmospheres Absolute. The resulting improvement in oxygen diffusion distance from functioning capillaries in a hypoperfused wound restores tissue oxygen tensions to appropriate levels. This effect has been confirmed by polarographic oxygen electrode measurements.

Elevation of wound oxygen tension promotes fibroblast division and collagen production to provide support for capillary proliferation.  This helps to prepare a rich vascular bed for skin grafting in venostasis ulcers, certain diabetic ulcers with reasonable regional perfusion and open amputation stumps. Increased oxygen tensions also enhance leukocyte responses in the treatment of chronic refractory osteomyelitis. Hyperbaric oxygen induced vasoconstriction has been beneficial in injuries producing tissue edema, such as crush injuries or compartment syndromes.

Oxygen is toxic to certain anaerobic bacteria and enhances the activity of certain antibiotics.  Cessation of toxin production by clostridial organisms in gas gangrene has been demonstrated. HBO results in rapid dissociation of carbon monoxide molecules from hemoglobin and provides sufficient quantities of physically dissolved oxygen to hypotoxic tissues in carbon monoxide poisoning. The mechanical effect of HBO results in decreasing the size of inert gas bubbles, which makes this therapy the primary mode of treatment for decompression sickness and acute gas embolism.