Transcutaneous Oxygen Measurements Under Hyperbaric Oxygen Conditions as a Predictor for Healing of Problem Wounds

Strauss, Michael B.; Bryant, Brandon; Hart, George B.

doi:10.1177/107110070202301008

Cited by 25 publications

(10 citation statements)

References 4 publications

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“…Therefore, it is not surprising that patients having higher TcPO 2 values have better odds for wound healing. This finding is in accordance with previous published results showing the prognostic role of in chamber TcPO 2 values …”

Section: Discussionsupporting

confidence: 94%

Prognostic factors predicting ischemic wound healing following hyperbaric oxygenation therapy

Feldman-Idov

Melamed

Linn

et al. 2013

Wound Repair Regeneration

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Identifying patients who benefit from hyperoxygenation therapy is important, because treatment is time-consuming and involves high costs and complications (minor). Our objective was to develop a model for predicting therapy outcome based on population of patients with and without diabetes. A retrospective cohort study was carried out in a major hospital in Israel. All 385 patients treated between 1/1/1998 and 1/1/2007 for ischemic nonhealing lower extremities wounds were included. Data on medical history, demographic, transcutaneous oximetry, wounds, treatment, and outcome characteristics were collected. Eight factors were identified to optimally predict wound healing: (1) number of hyperbaric oxygenation treatments (odds ratio [OR] = 1.034, p < 0.001), (2) transcutaneous oximetry values at hyperbaric conditions (OR = 1.001, p = 0.019), (3) wound duration (OR = 0.988, p = 0.022), (4) absence of heart disease (OR = 3.304, p < 0.001), (5) being employed (OR = 3.16, p = 0.008), (6) low socioeconomic status (OR = 2.50, p = 0.004), (7a) good/partial granulation wound appearance (OR = 2.73, p = 0.022), (7b) wounds covered with fibrin (OR = 3.16, p = 0.015), and (8) absence of anemia (OR = 2.13, p = 0.016). The model's sensitivity is 78.7%, specificity is 62.9%, and accuracy is 71.8%. We suggest using our model as an adjunct to patients' clinical evaluation. Also, we recommend initiating hyperoxygenation therapy no later than 2 months after wound appearance.

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Section: Discussionsupporting

confidence: 94%

Prognostic factors predicting ischemic wound healing following hyperbaric oxygenation therapy

Feldman-Idov

Melamed

Linn

et al. 2013

Wound Repair Regeneration

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“…We measured in-chamber PtcO 2 in only 17% of our patients, and as a result must apply a caveat that this subset could have incorporated undetected bias. However, our analysis of the relationship between these values and outcome in this group is similar to those reported by Strauss et al 25 There is an advantage, therefore, in using a model that incorporates multiple patient factors rather than focusing on only one.…”

Section: Discussionsupporting

confidence: 84%

Factors influencing the outcome of lower‐extremity diabetic ulcers treated with hyperbaric oxygen therapy

Fife¹,

Buyukcakir

Otto

et al. 2007

Wound Repair Regeneration

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The objectives of this study were to report outcomes of a large number of patients receiving hyperbaric oxygen therapy (HBO(2)T) for diabetic lower-extremity ulcers, and to identify likely outcome predictors. Five hyperbaric facilities supplied data on 1,006 patients. A sixth clinic served as a validation sample for the regression-based prediction model, and later additional data from Memorial Hermann Hospital were added. The severity of lower-extremity lesions was assessed upon initiation of HBO(2)T using the Modified Wagner scale, and the outcome described as healed, partially healed, not improved, amputated, or died. Overall, 73.8% of patients improved (granulated or healed). Factors significantly related to outcome included renal failure, pack-year smoking history, transcutaneous oximetry, number of HBO(2)T treatments, and interruption of treatment regimen. Number of treatments per week and treatment pressure (2.0 vs. 2.4 atmospheres absolute) were not significant factors in outcome. Concomitant administration of autologous growth factor gel did not improve outcome. A multiple regression model was fitted to the data that can be used to predict the outcome of diabetic patients undergoing HBO(2)T. Given the high cost of amputation and rehabilitation, these data suggest that hyperbaric oxygen treatment should be an important adjunctive therapy to heal lower-extremity lesions, especially those with a Wagner grade of 3 or higher.

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“…The paucity of randomized prospective clinical trials meeting the highest standards for evidence-based medicine has meant that hyperbaric oxygen therapy has failed to earn consensus recommendation as an effective therapeutic modality, although it is gaining increased acceptance for diabetic wounds. 17,18,[33][34][35] Regional oxygen therapy directed at a limb at hyperbaric or normobaric levels for varying periods of time is being marketed on the basis of anecdotal studies alone. 2 Despite this, isolated studies under controlled circumstances have documented clear improvements in wound healing in response to oxygen therapy in different forms.…”

Section: Commentmentioning

confidence: 99%

Transdermal Sustained-Delivery Oxygen Improves Epithelial Healing in a Rabbit Ear Wound Model

Said

Hijjawi²,

Roy³

et al. 2005

Arch Surg

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Transdermal sustained-delivery oxygen therapy improves wound healing. Design: Experimental study using a well-established rabbit ear model for acute wound healing. Setting: Wound-healing research laboratory in a university center. Methods: Four full-thickness 7-mm punch wounds were created on each ear of young, female New Zealand white rabbits. Treated ears received transdermal sustained delivery of oxygen via silicone tubing tunneled subcutaneously to a pocket under a semiocclusive dressing. Oxygen production (100% oxygen at 3 mL/h continuously) relied on a small, self-contained device connected to the silicone tubing and secured to the rabbit's back for the duration of the experiment using a body harness. Ears were harvested at each of 2 time points: day 5 and day 8. Results: Histologic analysis of the wounds showed significantly greater healing at both day 5 and day 8 in response to oxygen therapy. Most significantly, epithelial wound coverage was almost doubled in treated ear wounds when compared with controls. Conclusion: Our results suggest that epithelial wound healing is improved by transdermal sustained-delivery treatment with 100% oxygen.

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Transcutaneous Oxygen Measurements Under Hyperbaric Oxygen Conditions as a Predictor for Healing of Problem Wounds

Cited by 25 publications

References 4 publications

Prognostic factors predicting ischemic wound healing following hyperbaric oxygenation therapy

Prognostic factors predicting ischemic wound healing following hyperbaric oxygenation therapy

Factors influencing the outcome of lower‐extremity diabetic ulcers treated with hyperbaric oxygen therapy

Transdermal Sustained-Delivery Oxygen Improves Epithelial Healing in a Rabbit Ear Wound Model

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