Review of systemic lupus erythematosus

This article reports the results of a clinical study of 41 patients with mandibular osteoradionecrosis. Patients were divided into research arms to receive either post resection (of the radiation-damaged bone) hyperbaric oxygen (HBO) treatment, repeated debridement and clindamycin, or debridement and clindamycin without HBO. Assignment to HBO and no HBO groups was based on the availability of HBO at participating institutions. It is unclear from the article what means were used to standardize debridement protocols and success criteria. The authors found that patients receiving HBO not only did not receive a benefit, but also had poorer outcomes than did those not receiving HBO. The authors concede that the study numbers are relatively low but conclude that HBO should not be recommended for treatment of severe osteoradionecrosis after an initial resectioning of the involved mandible. They do appear to recommend following the protocol of preoperative and postoperative HBO for prevention and preresection of osteoradionecrosis.