HBO therapy should be considered as an important adjunct in the management of severe crush injuries. Besides adequate shock management and direct surgical intervention with debridement and repair of soft tissues, damaged vessels and stabilization of bony elements, supplemented by antibiotic and antithrombotic therapy, HBO therapy should be administered as soon as possible. Hyperbaric oxygen therapy must be seen as part of a therapeutical continuum, without any interruption of the chain of treatment. An early start of HBO therapy and an uncompromised application without restrictions to established surgical treatment and intensive care therapies is essential. Adjunctive treatment using hyperbaric oxygen requires not only a high standard of technical equipment in the hyperbaric chamber, but also a good amount of well trained medical personnel available 24 hours a day.

Still further clinical trials including controlled randomized trials are necessary to further prove the role of HBO therapy as an adjunct in the treatment of crush injuries.

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