Breast and chest wall

HBO has been used in the management of breast and chest wall

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injury ' - . Carl prospectively reported outcome in 44 patients presenting with pain, oedema, erythema, fibrosis and telangiectasia after lumpectomy and radiotherapy for early breast cancers. Complications were scored using modified LENT-SOMA criteria. Only patients with at least grade 3 pain or a summed LENT-SOMA score of 8 were studied. Thirty-two patients received a median of 25 sessions with 100% oxygen at 2.4 ata for 90 min. Patients who received HBO had a significant reduction of pain, erythema and oedema compared to those who refused HBO; however fibrosis and telangiectasia were not significantly reduced. Gothard245 reported a phase II trial in patients with chronic arm lymphoedema. The twenty-one patients received 30 sessions with 100% oxygen at 2.4 ata for 100 min over a period of 6 weeks. Arm volumes were measured in an operator-independent method. There was a statistically significant but clinically modest reduction in arm volume at 12 months follow-up; a controlled randomised trial is under development.

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