Evaluating the effect of a haemoglobin spray on size reduction in chronic DFUs

Abstract

The addition of a topical oxygenation therapy in this cohort of non-healing DFUs showed reduction in wound surface area and progression to healing. The product was also found to be acceptable and very easy to use by both participants and clinicians.

Systematic review of the efficacy of topical haemoglobin therapy for wound healing

“…Hunt et al also found that this was evident as early as the first week of treatment and was observed at all subsequent weeks, up to week 26 22 . Furthermore, all studies of chronic and non‐healing wounds found that such a therapy was effective in promoting wound healing, 15,24,27,31,33 with two studies demonstrating a positive reduction occurring in all patients 24,25 …”

“…All human research was conducted through the application of a haemoglobin spray (Granulox, SastoMed, Georgsmarienhütte, Germany). It should be noted that number of studies were part of a series, that is, the evaluation of patients at different time points following the intervention 14,15,22,23,25‐28 …”

“…In the present systematic review, the types of wounds treated with haemoglobin spray included chronic venous leg ulcers, 13,14,23,24,29 pressure ulcers, 14,30 chronic diabetic foot ulcers (DFU), 15,16,25‐27 sloughy wounds, 22,28,31 chronic/acute wounds from self‐harm, 17 or postsurgical wounds from pilonidal cysts 32 . The majority of studies targeted chronic or non‐healing wounds, that is, wounds that persisted for greater than 12 weeks 13,25,26,29 or decreased in size by less than 40% after a run‐in‐period (2 weeks for existing patients or 4 weeks for new patients) despite receiving local best practice 15,24,27,31,33 …”

“…The majority of studies reported the characteristics of the wound beds, especially the coverage of slough. Studies on chronic DFUs found that haemoglobin spray can markedly reduce the quantity of slough, 15,25‐27 and Hunt et al found that this method completely eliminated slough from chronic DFU patients in 4 weeks, compared with only a 10% reduction in the historical control group 26 . The superior desloughing effect was also confirmed in studies of other wounds (such as chronic venous leg ulcers, pressure ulcers, sloughy wounds) 13,14,22,24,28,33 .…”

“…Local haemoglobin therapy is a novel method of treatment based on the principle that haemoglobin can be applied topically to the wound bed as an aqueous solution to promote oxygen diffusion 14 . It is well known that haemoglobin is the natural oxygen transporter in humans, which can reversibly bind with oxygen 15 . In a hypoxic wound, haemoglobin sprayed on the wound binds oxygen from the surrounding air and transports it to the base of the wound, from which it diffuses into the cells at a rate that depends on the differential partial pressure of oxygen that exists between the wound bed and air.…”