The Presence of Oxygen in Wound Healing

Howard M. Kimmel, DPM, MBA; Anthony Grant, DPM; James Ditata, BSN, RN, CNOR

Disclosures

Wounds. 2016;28(8):264-270. 

In This Article

Oxygen Therapy

This review would be incomplete without a brief discussion of the use of oxygen in the treatment of wounds. Hyperbaric oxygen therapy (HBOT) is usually administered in a single patient or multipatient chamber that delivers 100% oxygen at 2 atmospheres of pressure. Hyperbaric oxygen therapy has proven to raise tissue oxygen 10 to 20 fold above room air.[55] One theory as to why HBOT might work is the synergy with PDGF since PDGF requires oxygen-derived hydrogen peroxide for functioning.[56] Another oxygen therapy is topical oxygen. This therapy utilizes either a chamber or a plastic bag to create a closed environment to deliver 100% oxygen converted from room air.[57] It is hypothesized that 100% oxygen applied locally to a wound increases VEGF expression, which may induce angiogenesis.[58] The evidence for clinical use of HBOT is moderate at best. In a review from the Cochrane Library Database, Kranke et al[59] presented 12 randomized trials that included participants with foot ulcers/wounds and diabetes. Short-term (up to 6 weeks) HBOT was found to be effective in improving healing but there were no significant findings that the wounds were completely healed after 1 year. For chronic wounds in patients with decreased blood supply or pressure ulcers, no evidence could confirm or deny any effects of HBOT.[59] In another study, Fedorko et al[60] published a randomized, placebo-controlled study for patients with both types I and II diabetes, diabetic wounds, or lower extremity injuries. Hyperbaric oxygen therapy did not offer any additional advantages in wound care nor did the therapy support a reduction in lower limb amputations or wound size in patients with diabetic foot ulcers over a 12-week period.[60]

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