Scar Tissue...

[dlarbale]

For all you medics,

I had a serious m/cycle accident just over a month ago and as a result I lost an eye and had to have extensive facial surgery (also had a few other breaks/fractures).

My diving before the accident was mainly deco dives and I'm aware that someone at some point has made a link between scar tissue and DCI susceptibility.

So, what evidence is there to support this. Has anyone on this board received a DCI hit due to scar tissue - ie. around an injury area? DCI normally shows up first through joint pain, does this mean that areas of low blood flow are less prone to problems (ie. facial tissue)?

What recomendations are there for returning to diving after an accident. My main focus at the moment is getting dive fit, after that I'll get a complete doctors checkup and then jump in a local pool. Am I missing anything there, and what should I do next?

Any thoughts or comments greatly received.

Thanks - Dave.

 

[BillP]

Howdy Dave:

Sorry to hear about your accident. To the best of my knowledge, the relationship between scar tissue and DCS is theoretical. Scarred tissue has had its normal blood flow disrupted. The thinking is that with the altered blood flow an area of scar might have difficulty offgassing on ascent and could be prone to localized DCS in the area of prior injury. I would dare to say that few authorities would consider this theoretical concern a reason to give up diving.

In general a diver can return to diving after pretty much any kind of surgery when the skin wounds have healed adequately, the muscle incisions are strong enough to take the strain of diving, the patient has recovered sufficiently otherwise to allow vigorous activity, the original condition they had the surgery for has improved enough/resolved so it doesn't interfere with diving, there are no significant complications or associated conditions that would interfere with diving, and the patient's doctor says it's OK.

A special consideration to keep in mind with major facial trauma would be the potential for a coexistant sinus injury that could interfere with equalizing.

Good luck with your recovery.

Bill

The above information is intended for discussion purposes only and is not meant as specific medical advice for any individual.

 

[Dr Deco]

Dear Dave:

Scars and DCS

With respect to the topic of decompression sickness and scar tissue, the two would basically not be related. If there were to be gas bubble growth in scare tissue, it would not lead to gas phase growth in the joint tissue. Many individuals have cuts, scrapes and scars with not effect with respect to decompression.

Animal Studies

It was common for those of us who worked with animals and decompression sickness (pigs and sheep, for example) to surgically implant Doppler blood flow probes on blood vessels. These lesions (cuts or injuries) did not result in changes in the decompression response of these animals, not did it change the presentation (change in the ratio of joint pain to neurological difficulties) of DCS.

Direct injury to a joint may be a different matter. In my experience in the laboratory, this can cause problems with joint-pain DCS in humans.

Dr Deco :doctor:

 

[pdoege]

Hey -

I had a bicycle accident. Lots of scar tissue. Still have the eye, but it is mostly metal now. Metal knee and shoulder too!

Anyway, it took a long time to get my leg strength back up. Shoulder took a long time too.

"A long time" is about 3 years.

No adverse affects to diving so far. I have lost some range of motion. I'm a bit slower getting geared up then the young guys.

Certainly no DCS issues.

Bummer about the facial reconstruction. I would try some shallow stuff to make sure that the sinuses clear.

I'd be tempted to get a physical and chat with my doctor for a bit.

Peter Doege

 

[dlarbale]

Thanks for the info guys. I've met a few people who have significant scars and still dive but none of them are into technical / decompression diving so couldn't really draw any conclusion.

I'll make sure I get the doc checkup and also take it easy (to begin with at least!).

Dave.

PS// Peter, what sort of profiles have you done since the op?

 

[andibk]

Dave,
Sorry to hear about your accident. Hope you have a quick recovery. Next time you are in Thailand drop me a line we can go out for a few drinks. I will be leaving to Florida in MArch/April will be doing all my cave courses. Plan on checking out some caves in Southern Thailand later this year. Get well soon.

Bruce

 

[sierradiver]

What is it with "Dave"s. I'm one too, and I took a steel channel into the left side of my face, eight facial breaks, five titanium plates and one reconstructive surgery later, I'm two months out from it.

I appreciate your info and will start diving with a little more comfort factor than before. I'll go slow and careful but relaxed.

David

PS, Dave, I hope you are feeling better every day.