ROCKINGHAM – In February 2008, when Ellerbe resident Ray Von Chambers was referred to the Wound Care & Hyperbaric Center at FirstHealth Richmond Memorial Hospital, he was dangerously close to losing both his legs.

No one – not Chambers, not the surgeon in charge of his care, not the Wound Care Center staff – is exactly sure how his ordeal began. But by the time Chambers reached Leslie J. Salloum, M.D., and the Wound Care Center, the problem that started with awful itching and large, wet blisters had progressed to a condition with the intimidating name of necrotizing fasciitis (decaying infection of the flesh).

Sixteen months later, however, the 52-year-old Chambers is on the mend – and still walking on his own two legs.

“I’ve been real pleased,” Chambers says of the treatment he received from Dr. Salloum and the Wound Care Center staff. “I’ve still got my legs.”

According to the National Necrotizing Fasciitis Foundation, necrotizing fasciitis is a bacterial infection that is commonly caused by a group of Strep bacteria, the same bacteria that cause Strep throat. Although usually easily controlled with antibiotics, Strep sometimes turns into a very strong variety like the type that caused Chambers’ problem.

Usually, the bacteria enter the body through an opening in the skin, often a very minor opening, even as small as a paper cut or a pin prick. They can also enter through weakened skin, like a bruise or a blister, or even after a major trauma or surgery. In some cases, there is no obvious point of entry.

Chambers’ poor health probably contributed to his condition. The former hosiery mill worker is disabled because of gout, congestive heart failure, arthritis and diabetes.

A 1996 report from the Centers from Disease Control and Prevention estimates there are from 500 to 1,500 cases of necrotizing fasciitis per year. Of that number, about 20 percent die. According to the Necrotizing Fasciitis Foundation, only one thing can decrease the risk of disfigurement and death and that is prompt diagnosis.

A quick diagnosis unquestionably made a difference in Chambers’ case. When Dr. Salloum first saw Chambers’ bacteria-ravaged legs, he recognized the problem and moved quickly to address what he identified as certainly a limb-threatening and possibly a life-threatening situation by taking him to the operating room for debridement (removal) of the affected tissue.

He describes Chambers’ case as “very advanced” and requiring the removal of 50 to 60 percent of the skin and subcutaneous tissue (the layer of fat and connective tissue that houses larger blood vessels and nerves) in the affected area.

“When I saw him initially, I thought he was going to lose both legs,” Dr. Salloum says.

Chambers thought so, too. “It was real bad on both legs,” he says.

Addressing Chambers’ problem required almost every treatment that Dr. Salloum and the Wound Care Center could provide. After the initial debridement, Chambers spent several months in Richmond Memorial Hospital’s Palmer Hinson Care Center where his fluid-soaked bandages could be changed as often as needed and where he got what Dr. Salloum calls “broad spectrum antibiotics.” He was also fitted with compression boots that covered his legs from the knees to the toes.

There were more debridement procedures and finally six weeks of two-hour treatments each weekday in the Wound Care Center’s hyperbaric chamber – the latter exposing Chambers to levels of 100-percent oxygen at greater-than-normal pressure.

Although at first intimidated by the thought of being enclosed in the tube-like hyperbaric chamber, Chambers adapted to the procedure and soon became relaxed enough to watch TV during his treatment.

“You had to kind of get used to being there,” he says. “The pressure is like being in a plane, the pressure in your ears, but you get used to it.”

According to Dr. Salloum, the high oxygen levels of hyperbaric treatment support the growth of new blood vessels, kill bacteria and reduce edema, all of which are necessary to heal problem wounds. “Wound care and hyperbaric oxygen therapy form a powerful tool to help wounds to heal,” he says.

But not every wound care patient needs pure oxygen treatment. Dr. Salloum calls hyperbaric an “adjunctive” but not always necessary part of a wound care plan. Benita Watson, R.N., who supervises the wound program at Richmond Memorial, agrees.

“Some patients never use the chamber,” she says. “Some come only for the chamber. It depends on the diagnosis.”

For Chambers, pure-oxygen exposure completed the comprehensive treatment plan that resulted in his positive outcome. He had his last appointment with Dr. Salloum at the Wound Care Center on June 24. His legs were pronounced healed, and he was discharged from the Center’s care.

“We’re happy; he’s happy; he’s still walking with his own legs,” says Dr. Salloum.

For more information on the FirstHealth Wound Care & Hyperbaric Center at FirstHealth Richmond Memorial Hospital, please call (910) 417-3636.