EUBS Members Help Requests

Research Collaboration Requests

February 2, 2024

Nikolett Szolnoki MD, is the Medical Director of Balance Medical Center, Lenti, Hungary, and writes the following:

Dear EUBS Members, dear Colleagues!

I was approached by an orthopaedic surgeon colleague. He has successfully used hyperbaric oxygen therapy in several cases of periprosthetic joint infection (PJI) patients after revision surgery. He has managed to significantly reduce the re-infection rate of revision prosthesis by using additional adjuvant HBOT along to conventional therapies. He informed me that the European Society of PJI is holding consensus meetings to define the PJI best practice therapeutic procedure, question is raised could HBOT be included? This of course requires more data and publications on the subject. He suggested to get information if other hyperbaric oxygen therapy centers might have their own  case report experience in PJI postoperative HBOT treatment. 
If your HBOT center has treated PJI orthopedic patients post revisio surgery please kindly share your experience, treatment regimen.  We plan the processing of the collected material. 
Hopefully, on this basis we can contribute to the PJI orthopaedic consensus committee to include HBO as a best practice procedure in selected special cases. 
I look forward to hearing from you in the hope of cooperation,
Yours collegially,

Nikolett Szolnoki MD,

dr. Szolnoki Nikolett
orvos igazgató
hiperbár oxigénterápiás orvos
Balance Medical Center
8960 Lenti, Táncsics Mihály utca 2/a.
+36 20 778 5943 recepció
+36 20 325 8535 HBOT centrum

Medical Requests

January 1, 2024

Peter Germonpré is Medical Director of the Centre for Hyperbaric Oxygen Therapy of the Military Hospital Brussels, and writes the following:

We are currently following a young male person (born 1981) who suffers since 10 years from severe wound healing problems after implantation of an ICD for diagnosed Brugada disease. On three occasions, the ICD has had to be removed for non-healing implantation site, and even now (no ICD in place anymore), the last implantation site has become a chronic, easily bleeding, extended skin and subcutaneous tissue defect, without signs of proper granulation let alone successful skin grafting and flap surgery. He has been followed consecutively at two university plastic surgery departments who basically “gave up” after multiple surgeries, including DIEP flap, multiple skin grafts, as well as NPWT, PGF, keratinocytes,…).

Diagnosis of Ehlers-Danlos Disease was suspected but not confirmed (genetic test negative, Beighton score 5/9). Electron-microscopic examination of the skin has been performed in the past and showed disturbed collagen pattern, with reduced fibre content and cauliflower aspect. No specific diagnosis suggested. A recent suggestion of Pyoderma Granulosum was not confirmed by biopsy.

Hyperbaric oxygen treatment has been performed before (2015 – 30 treatments with limited effect and no final healing; up to May 20, 2019 20 more treatments with clinically no effect. Serial biopsies no significant evolution. Anemic, needs blood transfusions every 2-3 weeks as blood loss from wound dressings is significant.

No other known pathology. No medication. No blood or coagulation disorder identified. No other family members affected (except maybe 8 year old son, who seems to be “healing small wounds with some difficulty”). Psychiatric evaluation negative for possible auto-affliction.

See small pictures below. If any EUBS member can help identifying this disease of can offer other suggestions, please contact me for further clinical info and pictures.

Peter Germonpré