Therapeutic Effects of Hyperbaric Oxygen in the Process of Wound Healing

Abstract

Chronic and non-healing wounds, especially diabetic foot ulcers and radiation injuries, imply remarkable morbidity with a significant effect on the quality of life and a high sanitary cost. The management of these wounds requires complex actions such as surgical debris, antibiotic treatment, dressings and even revascularization. These wounds are characterized by poor oxygen supply resulting in inadequate oxygenation of the affected tissue. The adjuvant treatment with hyperbaric oxygen therapy (HBOT) may increase tissue oxygenation favoring the healing of wounds which do not respond to the usual clinical care. The increase in the partial pressure of oxygen contributes to cover the energy demands necessary for the healing process and reduces the incidence of infections. Moreover, the increase in oxygen leads to the production of reactive species with hormetic activity, acting on signaling pathways that modulate the synthesis of inflammation mediators, antioxidants and growth factors which can contribute to the healing process. Studies performed with cell cultures and in animal models seem to demonstrate the beneficial effects of HBOT. However, clinical trials do not show such conclusive results; thus, additional randomized placebo-controlled studies are necessary to determine the real efficacy of HBOT and the mechanism of action for various types of wounds.

Integrin-mediated adhesive properties of neutrophils are reduced by hyperbaric oxygen therapy in patients with chronic non-healing wound

“…HBOT is used as a safe adjunctive therapy for chronic non-healing wound [45,[50][51][52][53]. Wound healing is a complex and a tightly regulated process that requires a well-orchestrated interplay of molecular and cellular events and that can be divided into several stages: hemostasis, inflammation, re-epithelialization and tissue remodeling [54].…”

Oxidative Stress Markers to Investigate the Effects of Hyperoxia in Anesthesia

“…This mechanism may explain the slight decrease of hydroperoxides (measured as dROMs) during surgery with no increase after surgery. MDA can also be considered as a chemoattractant for immunity cells [27], which may play a role in the previously reported [12,28] effects of O 2 on wound healing. In addition, the production of MDA is best related to the intensity of exposure to hyperoxia during surgery, rather than to the total O 2 dose during the entire observation time of the subjects.…”

Comparative Evaluation of Different Chitosan Species and Derivatives as Candidate Biomaterials for Oxygen-Loaded Nanodroplet Formulations to Treat Chronic Wounds

“…Another important issue revolves around medical therapy, as the effectiveness of treatments often decreases while tissue necrosis can develop in hypoxic conditions [9]. Oxygen tissue levels can be adequately bolstered by hyperbaric oxygen therapy (HBOT) [10], while an alternative therapy is represented by topical oxygen therapy (TOT) [11]. Unfortunately, either HBOT or TOT display various backwards.…”