Hyperbaric oxygen and wound healing
27 November 2019 (online)
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.
KEY WORDSAir embolism - compartment syndrome - crush syndrome - decompression sickness - diabetes mellitus - diabetic foot - gas gangrene - hyperbaric medicine - hyperbaric oxygen therapy - hyperbaric oxygenation - necrotising fasciitis - osteomyelitis - osteoradionecrosis - radiation injuries - radiation necrosis - reperfusion injury - soft tissue infections - surgical fl aps - transcutaneous oximetry
- 1 Sahni T, Hukku S, Jain M, Prasad A, Prasad R, Singh K. Recent advances in hyperbaric oxygen therapy. Medicine update. Assoc Physicians India 2004;14:632-9.
- 2 Neubauer RA, Maxfield WS. The polemics of hyperbaric medicine.J P and S 2005;10:15-7.
- 3 Latham E, Hare MA, Neumeister M. Hyperbaric oxygen therapy. eMedicine. Schraga BD, Windle ML , Mosenifar Z, editors. Medscape. Available from: http://emedicine.medscape.com/article/1464149-overview. [Last accessed on 2009 Oct 02] [Last updated on 2008 Nov 7].
- 4 Sharkey S. Current indications for hyperbaric oxygen therapy.Journal of the Australian Defence Health Service (ADF Health) 2000;1:64-72.
- 5 Indications for hyperbaric oxygen therapy. In: Definition of Hyperbaric Oxygen Therapy. UHMS. Available from: http://membership.uhms.org/?page=Indications [Last accessed on 2012 Jan 10].
- 6 Camporesi EC, editor. Current diseases approved for treatment, hyperbaric oxygen therapy: A Committee Report. UHMS. Available from: http://hyperbaric.org.uk/conditionsTreatment.htm. [Last cited in 1996].
- 7 Proceedings of the 7 th European consensus conference on hyperbaric medicine. Lille, France: 2004. European committee for hyperbaric medicine.
- 8 Sahni T, Singh P, John MJ. Hyperbaric oxygen therapy: Current trends and applications. J Assoc Physicians India 2003;51:280-4.
- 9 Bhutani S. HBOT reduces fatigue in HIV positive patients. Jour Marine Medical Society 2011;13:57-9.
- 10 Vishwanath G. Hyperbaric oxygen therapy in free flap surgery: Is it meaningful? Medical journal armed forces India (MJAFI) 2011;67:253-6.
- 11 Michael N. Hyperbaric oxygen therapy. eMedicine. Cram AE, Talavera F, Newsome RE, Slenkovich NG, Torre JT, editors. Medscape. Available from: http://emedicine.com/plastic/topic526.htm. [Last accessed on 2005 May 20].
- 12 Leach RM, Rees PJ, Wilmshurst P. ABC of oxygen, hyperbaric oxygen therapy. BMJ 1998;317:1140-3.
- 13 Bhutani S, Verma R. Hyperbaric oxygen therapy in non-healing wounds. Jour Marine Medical Society 2010;12:89-92.
- 14 Doctor N, Pandya S, Supe A. Hyperbaric oxygen therapy in diabetic foot. J Postgrad Med 1992;38:112-4.
- 15 Löndahl M, Katzman P, Hammarlund C, Nilsson A, Landin-Olsson M. Relationship between ulcer healing after hyperbaric oxygen therapy and transcutaneous oximetry, toe blood pressure and ankle-brachial index in patients with diabetes and chronic foot ulcers. Diabetologia 2011;54:65-8.
- 16 Smart DR, Bennett MH, Mitchell SJ. Transcutaneous oximetry, problem wounds and hyperbaric oxygen therapy. Diving Hyperb Med 2006;36:72-86.
- 17 Matos L, Nunez A. Enhancement of healing in selected problem wounds. In: Hyperbaric Medicine Practice 2nd ed. Kindwall EP, Wheelan HT, editors. Florida: Best Publishing; 1999. p. 813-49.
- 18 Kemmer A. Crush injury and other traumatic ischemia. In: Mathieu D, editor. Handbook on hyperbaric medicine. Netherlands: Springer; 2006. p. 311-2.
- 19 Mesimeris TA. Compromised skin graft and flap. In: Mathieu D, editor. Handbook on hyperbaric medicine. Netherlands: Springer; 2006. p. 329-61.
- 20 Pasquier D, Schmutz J, Lartigau E. Radio-induced lesion in normal tissues. In: Mathieu D, editor. Handbook on hyperbaric medicine. Netherlands: Springer; 2006. p. 363-99.
- 21 Germonpre P. Burns. In: Mathieu D, editor. Handbook on Hyperbaric Medicine. Netherlands: Springer; 2006. p. 479-94.
- 22 Hart GB, O′Reilly RR, Broussard ND. Treatment of burns with hyperbaric oxygen. Surg Gynecol Obstet 1974;139:693-6.
- 23 Bhutani S. Hyperbaric oxygen therapy. Poster presentation at: XXIV Annual Conference of the Marine Medical Society. Mumbai: Marine Medical Society; 2009. p. 24-5