Hyperbaric Oxygen Therapy for Crush Injuries and Compartment Syndrome
Crush injuries and compartment syndrome are serious traumatic conditions that can result in extensive tissue damage, loss of function, and life-threatening complications if not treated promptly. These injuries commonly occur following accidents, heavy compression, or prolonged pressure on a limb. Alongside emergency surgical and medical care, Hyperbaric Oxygen Therapy (HBOT) is used in selected cases to support tissue survival, reduce complications, and improve recovery outcomes.
HBOT works by increasing oxygen delivery to damaged tissues, particularly where swelling and compromised circulation restrict normal blood flow.
Understanding Crush Injuries
Crush injuries occur when a body part is subjected to significant force or pressure, damaging muscles, nerves, blood vessels, and surrounding tissues. They are frequently seen in industrial accidents, road traffic collisions, structural collapses, or prolonged limb compression.
Even after the external pressure is relieved, internal swelling and tissue breakdown can continue, leading to reduced blood supply and the release of harmful by-products into the bloodstream. Without careful management, crush injuries can progress to infection, tissue necrosis, or systemic complications.
What Is Compartment Syndrome?
Compartment syndrome develops when swelling or bleeding increases pressure within a closed muscle compartment, restricting circulation and oxygen delivery. This pressure can rapidly cause muscle and nerve damage.
Symptoms may include severe pain disproportionate to the injury, tightness, reduced movement, sensory changes, and worsening swelling. Acute compartment syndrome is a surgical emergency and often requires urgent fasciotomy to relieve pressure.
How HBOT Supports Treatment
Hyperbaric Oxygen Therapy is used as an adjunctive therapy, supporting conventional surgical and medical management rather than replacing it.
Therapeutic Benefits of HBOT
1. Improves Oxygen Supply to Ischaemic Tissue
HBOT delivers oxygen at increased pressure, allowing oxygen to reach tissues where circulation has been impaired by swelling or vascular injury.
2. Reduces Tissue Oedema
The pressure environment helps reduce swelling, lowering compartment pressure and improving microcirculation.
3. Supports Muscle and Nerve Recovery
Enhanced oxygen availability promotes cellular repair and supports the recovery of damaged muscles and nerves.
4. Limits Secondary Tissue Damage
HBOT helps interrupt the cycle of hypoxia, inflammation, and cell death that can worsen crush injuries over time.
HBOT Within a Multidisciplinary Care Pathway
For both crush injuries and compartment syndrome, HBOT is used alongside urgent interventions such as surgery, fracture management, wound care, and infection control. It is typically introduced after pressure has been relieved surgically or once the patient is stabilised.
Treatment protocols are tailored to the severity of injury, extent of tissue damage, and response to initial care. Multiple sessions may be recommended over a defined period to support healing and reduce the risk of long-term complications.
Use of HBOT in the UK
In the UK, HBOT for traumatic injuries is delivered through accredited hyperbaric centres following referral from hospital trauma or orthopaedic teams. Treatment is guided by recognised clinical indications and delivered under specialist supervision, with continuous monitoring to ensure patient safety.
Recovery and Clinical Outcomes
- Improved tissue survival
- Reduced risk of infection and necrosis
- Better functional recovery
- Lower likelihood of long-term disability
Outcomes depend heavily on early diagnosis, rapid surgical intervention, and timely referral for adjunctive therapies such as HBOT.
FAQs About Crush Injuries, Compartment Syndrome, and HBOT
No. Surgical intervention is essential for compartment syndrome. HBOT supports recovery after pressure relief.
HBOT is most beneficial when introduced early in the recovery phase, once circulation has been restored or stabilised.
In some cases, HBOT may help preserve tissue and improve healing, potentially reducing the extent of surgical intervention.
Yes, when administered in a controlled setting and following patient assessment, HBOT is considered safe and well tolerated.
The number varies depending on injury severity and response to treatment, with care plans tailored to each individual.
Crush injuries and compartment syndrome are complex, time-critical conditions that require rapid, coordinated medical care. Hyperbaric Oxygen Therapy offers valuable support by enhancing oxygen delivery, reducing swelling, and promoting tissue recovery in selected cases. When used as part of a multidisciplinary treatment strategy, HBOT can play an important role in improving outcomes and supporting long-term recovery following severe traumatic injury.