Enhancement of Healing in Problem Wounds

Problem wounds are those that fail to respond to established medical and surgical treatment. Such wounds usually develop in compromised areas with multiple factors contributing to the inhibition of tissue repair. These include diabetic feet, compromised amputation sites, non-healing traumatic wounds and vascular insufficiency ulcers (ulcers with poor circulation). All share the common problem of tissue hypoxia or low oxygen levels in the tissues, usually related to impaired circulation.

Diabetic foot wounds are one of the major complications of diabetes and an excellent example of the type of problem wound which can be treated with hyperbaric oxygen. Many people with diabetes suffer from circulatory disorders that create inadequate levels of oxygen to support wound healing. Fifty percent of all lower extremity amputations in the United States are due to diabetes.

With hyperbaric oxygen therapy, patients receive high concentrations of oxygen under pressure to increase the oxygen level in the blood and tissues. The elevation in oxygen in the tissues induces significant changes in the wound repair process that promote healing. When used in conjunction with standard wound care, hyperbaric oxygen has shown improved results in the healing of difficult wounds as compared to routine wound care alone.

References:

  1. Cianci P. Adjunctive hyperbaric oxygen in the treatment of problem wounds: An economic analysis. In: Kindwall E, ed. Proceedings of the Eighth International Congress on Hyperbaric Medicine. San Pedro, CA: Best Publishing. 1984:213-216.
  2. Cianci P, Petrone G, Drager S, Lueders H, Lee H, Shapiro R. Salvage of the problem wound and potential amputation with wound care and adjunctive hyperbaric oxygen therapy: An economic analysis. J Hyperbaric Med 1988;3:127-141.
  3. Hunt TK. The physiology of wound healing. Ann Emerg Med 1988;17:1265-1273.
  4. Stone JA, Cianci P. The adjunctive role of hyperbaric oxygen therapy in the treatment of lower extremity wounds in patients with diabetes. Diabetes Spectrum 1997;10:118-123.
Center for Hyperbaric Medicine