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The primary concern with respect to one’s risk of DCI isn’t
the hole, it’s the bubble load. Thus, the cautious thing to do is to
minimize your bubble load by diving conservatively. If you were
my patient, I would support recreational diving on the richest
nitrox mix allowable for your depth with prolonged safety stops
using the same mix or a richer mix if your level of certification
allows. I definitely would NOT recommend closing the hole
before returning to diving; the risk of significant complication
from that procedure is around 1 percent, which is much higher
than the risk of DCI with leaving it alone (0.1 percent).
While it is reasonable to wait and see if it closes spontaneously
before you return to diving, it is also reasonable to resume diving
(with the caveats listed) despite the defect, knowing there is an
increased, albeit small, absolute risk of DCI.
— Douglas Ebersole, M.D.
Q:
I do a lot of diving; as a result of handling
tanks, lines, ladders and other gear, I usually
have a cut or two somewhere — typically on my
hands. Should I be concerned about getting an infection
while diving?
A:
Skin is the body’s primary barrier against infection.
Breaks in the skin, therefore, enable skin bacteria
and the abundance of microscopic life in seawater to
contaminate vulnerable subdermal (beneath the skin) tissues.
The diving environment can compromise skin integrity.
Prolonged immersion and high humidity may alter the skin’s
pH and soften the outer layer of the epidermis, causing peeling
(desquamation), further reducing the skin’s natural defenses
and enabling infection — overgrowth of bacteria or other
microorganism within a wound. For cuts and scrapes that
occur in or around water (including lakes, streams and oceans)
thorough cleaning with soap and water is recommended,
followed by the application of a protective dressing. People with
open wounds should refrain from entering the water until healing
is complete. Maintain an up-to-date tetanus vaccination to
minimize risk of infection by that pathogen.
AD
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