Is there a role for hyperbaric oxygen therapy in the treatment of refractory wounds of rare etiology?
| Autor: | Michael H Bennett, Pasquale Longobardi, Klarida Hoxha |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Cost-Benefit Analysis Review Article law.invention 030207 dermatology & venereal diseases 03 medical and health sciences Wound care 0302 clinical medicine Randomized controlled trial law medicine Humans Hyperbaric medicine Prospective Studies 030212 general & internal medicine Intensive care medicine Hyperbaric Oxygenation Wound Healing Calciphylaxis integumentary system business.industry Public Health Environmental and Occupational Health medicine.disease Diabetic Foot Review article Etiology Vasculitis business Pyoderma gangrenosum |
| Zdroj: | Diving Hyperb Med |
| ISSN: | 2209-1491 |
| DOI: | 10.28920/dhm49.3.216-224 |
| Popis: | Introduction Delayed wound healing indicates wounds that have failed to respond to more than 4-6 weeks of comprehensive wound care. Wounds with delayed healing are a major source of morbidity and a major cost to hospital and community healthcare providers. Hyperbaric oxygen therapy (HBOT) is a treatment designed to increase the supply of oxygen to wounds and has been applied to a variety of wound types. This article reviews the place of HBOT in the treatment of non-healing vasculitic, calcific uremic arteriolopathy (CUA), livedoid vasculopathy (LV), pyoderma gangrenosum (PG) ulcers. Methods We searched electronic databases for research and review studies focused on HBOT for the treatment of delayed healing ulcers with rare etiologies. We excluded HBOT for ulcers reviewed elsewhere. Results We included a total of three case series and four case reports including 63 participants. Most were related to severe, non-healing ulcers in patients with vasculitis, CUA, LV, and PG. There was some evidence that HBOT may improve the healing rate of wounds by increasing nitric oxide (NO) levels and the number of endothelial progenitor cells in the wounds. HBOT may also improve pain in these ulcers. Conclusion We recommend the establishment of comprehensive and detailed wound care registries to rapidly collect prospective data on the use of HBOT for these problem wounds. There is a strong case for appropriately powered, multi-centre randomized trials to establish the true efficacy and cost-effectiveness of HBOT especially for vasculitis ulcers that have not improved following immunosuppressive therapy. |
| Databáze: | OpenAIRE |
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