Hyperbaric oxygen and wound healing

Abstract

Hyperbaric oxygen therapy (HBOT) is the use of 100% oxygen at pressures greater than atmospheric pressure. Today several approved applications and indications exist for HBOT. HBOT has been successfully used as adjunctive therapy for wound healing. Non-healing wounds such as diabetic and vascular insufficiency ulcers have been one major area of study for hyperbaric physicians where use of HBOT as an adjunct has been approved for use by way of various studies and trials. HBOT is also indicated for infected wounds like clostridial myonecrosis, necrotising soft tissue infections, Fournier's gangrene, as also for traumatic wounds, crush injury, compartment syndrome, compromised skin grafts and flaps and thermal burns. Another major area of application of HBOT is radiation-induced wounds, specifically osteoradionecrosis of mandible, radiation cystitis and radiation proctitis. With the increase in availability of chambers across the country, and with increasing number of studies proving the benefits of adjunctive use for various kinds of wounds and other indications, HBOT should be considered in these situations as an essential part of the overall management strategy for the treating surgeon.

Effects of hyperbaric oxygen therapy on uncomplicated incisional and open wound healing in dogs

“…No protocol is available in veterinary medicine to standardize the number of treatments per day or total number of treatments for wound healing, although up to 3 hyperbaric oxygen sessions per day have been used in man. 35,36 The pressure, time of treatment, and frequency per day used in this study may have been insufficient to detect an observable effect on uncomplicated open and incisional wounds; however, the protocol used in this study was safe in this group of dogs, and an increase in pressure, treatment time, or frequency could increase the risk of adverse effects.…”

Chronic ulcers: MATRIDERM®system in smoker, cardiopathic, and diabetic patients

“…A series of small studies showed a more rapid healing and reduction of the amputations in patients treated with hyperbaric oxygen compared with control subjects. 16 The actual consensus recommendation is that hyperbaric oxygen therapy may be useful as adjuvant to standard presidium approach in the treatment of wounds in patients, but this field needs further investigation. Another treatment is the vacuum assisted closure (V.A.C.…”

Action of hyperbaric oxygenation in the rat skin flap

“…Molecular oxygen seems to play a central role in the wound healing process The hyperoxia caused by hyperbaric oxygenation (HBO) is responsible to increase tissue tolerance to ischemia, and improve biological defense mechanisms against free radicals, as well as the capacity of tissues to withstand ischemia 2 .…”