John Bartlett, MD

Disclosures

July 23, 2003

In This Article

Hyperbaric Oxygen for Soft-Tissue Infections

Wang C, Schwaitzberg S, Berliner E, Zarin DA, Lau J. Hyperbaric oxygen for treating wounds: a systematic review of the literature. Arch Surg. 2003;138:272-279. Abstract The authors review the literature from 1998 to 2001 for studies of hyperbaric oxygen (HBO) therapy as an adjunct treatment for wounds. There were 57 studies including 7 randomized controlled trials, 16 nonrandomized studies, and 34 case series with a total of 2000 patients. The rationale was based on the utility of HBO for hypoxic wounds, but none used tissue hypoxia as an inclusion criterion. The cumulative results suggested that HBO might be effective for chronic nonhealing diabetic wounds, compromised skin grafts, osteoradionecrosis, soft tissue radionecrosis, and gas gangrene. The major toxicity was seizures and pneumothorax. The authors conclude that the overall study quality was poor due to the lack of adequate controls, there was inadequate evidence about criteria for use, there may be serious adverse effects, and there is a great need for randomized, controlled trials.

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