ABSTRACT

Avcı AU, Abaylı SY. The Experience of Hyperbaric Oxygen Therapy in Earthquake-Related Crush Injuries: Could Be Beneficial Even with Delay in Initiation. Undersea Hyperb Med. 2025 Third Quarter; 52(3):261-270.

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.

Keywords: crush injuries; hyperbaric oxygen therapy; hyperbaric medicine; trauma