Australian Government - Department of Health and Ageing

Medical Services Advisory Committee (MSAC)

1054.1 - Review of Interim Funded Service: Hyperbaric Oxygen Treatment (HBOT)

Application No.

1054.1

Application NameReview of Interim Funded Service: Hyperbaric Oxygen Therapy (HBOT) for the Treatment of Chronic Non-Diabetic Wounds and Non-Neurological Soft Tissue Radiation Injuries
Description Of Intervention(1) Late Soft Tissue Radiation Injury
Late soft tissue radiation injury is a complication experienced by a minority of individuals who successfully recover from radiation treatment for cancer. It occurs when healthy adjacent tissue is damaged in the process of treating cancer with radiotherapy. The damage to healthy tissue may not become apparent for months or years after treatment. Radiotherapy technology and techniques are rapidly advancing and side effects are becoming fewer. Examples of the impact on affected individuals include: ulceration in the mouth, impairment of speech, skin ulceration with persistent non-healing painful wounds and infections in body regions that have received radiotherapy, bleeding from the bladder or bowel, or incontinence. Life-threatening infections may also result from untreated bladder or bowel radiation injury. There are limited treatment options available for this condition, and the evidence supporting all treatments is also limited.

(2) Chronic Refractory Skin Ulcers and Wounds
Chronic or refractory problem wounds are skin ulcers and wounds that persist longer than 3 months and do not respond to standard treatment. The wounds require visits to health facilities or home care visits by community healthcare workers for months or years. Complications are frequent and may require admission to hospital. The true incidence, impact and cost are difficult to assess accurately given the wide range of disease, lack of high quality scientific studies of treatments. Approximately 1% of the population of industrialised countries will experience a chronic leg wound at some time, while the prevalence in hospital patients has been estimated at 24%. Many of these wounds are associated with circulatory disorders and lack of oxygen can be a contributing factor.
Description Of DiseaseHyperbaric Oxygen Therapy (HBOT) involves placing the patient in a compression chamber, increasing the pressure within the chamber, and administering 100% oxygen for breathing. In this way, it is possible to deliver a greatly increased pressure of oxygen to the patient’s body tissues. The pressure of oxygen delivered to the patient is increased by 12 to 15 fold and oxygen is able to diffuse further into the diseased tissue. Healing is assisted by providing sufficient oxygen at a cellular level to restore normal function. This reduces swelling and also inhibits some bacteria that would otherwise thrive in a low oxygen environment. Treatments are delivered once or twice daily and typically last between 60 and 120 minutes. A typical course might involve 20 to 30 treatments, in order to heal long standing wounds or radiation injuries.
Advisory PanelProfessor John Horvath
Chair
MSAC Member (until 31/12/2010)
Dr Christine Tippett
Deputy Chair
MSAC Member
Mr Malcolm Wells
Consumer Health Forum Nominee
A/Prof David Smart
Hyperbaric Medicine specialist
Dr Liz Kenny
Oncologist
Dr Michael Bennett
Hyperbaric Medicine specialist
A/Prof Michael Leung
Plastic & Reconstructive Surgeon
Date Received by MSAC Secretariat04/02/2010
Stage 1 - Eligibility23/02/2010
Stage 2 - AssessmentIn progress
Stage 3 - Formulation of Advice to the Minister
Stage 4 - Decision
Stage 5 - Implementation

Page currency, Latest update: 15 September, 2011