Potential markers of healing from near infrared spectroscopy imaging of venous leg ulcer. A randomized controlled clinical trial comparing conventional with hyperbaric oxygen treatment

Autor:	Valentina Hartwig, Klarida Hoxha, Flavio Coceani, Antonio L'Abbate, Luigi Santarella, Jhonny Campos, Maria Giovanna Trivella, Pasquale Longobardi, Monica Rocco, Marco Laurino, Pietro Salvo
Rok vydání:	2020
Předmět:	nirs Male Dermatology Venous leg ulcer Group B Varicose Ulcer 030207 dermatology & venereal diseases 03 medical and health sciences Hemoglobins 0302 clinical medicine Hyperbaric oxygen Oxygen Consumption Compression Bandages venous leg ulcers Medicine Humans hyperbaric oxygen therapy Aged Hyperbaric Oxygenation Wound Healing Spectroscopy Near-Infrared business.industry Intensive treatment % area reduction medicine.disease Clinical trial Wound area Treatment Outcome Anesthesia Surgery Female Once daily business Biomarkers
Zdroj:	Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair SocietyREFERENCES. 28(6)
ISSN:	1524-475X
Popis:	The aim of this study is to ascertain whether the simultaneous measurement of hemoglobin O2 saturation (StO2 ) and dimension of venous leg ulcers (VLU) by near infrared spectroscopy (NIRS) imaging can predict the healing course with protocols employing a conventional treatment alone or in combination with hyperbaric oxygen therapy (HBOT). NIRS 2D images of wound region were obtained in 81 patients with hard-to-heal VLU that had been assigned, in a randomized controlled clinical trial, to the following protocols: 30 HBOT sessions, adjunctive to the conventional therapy, either twice daily over 3 weeks (group A) or once daily over 6 weeks (group B), and conventional therapy without HBOT (group C). Seventy-three patients completed the study with a total of 511 NIRS images being analyzed. At the end of treatment, wound area was significantly smaller in all three groups. However, at the 3-week mark the wound area reduction tended to be less evident in group A than in the other groups. This trend continued up to the 6-week end-point when a significantly greater area reduction was found with group B (65.5%) and group C (56.8%) compared to group A (29.7%) (P < .01). Furthermore, a higher incidence of complete healing was noted with group B (20%) than with group A (4.5%) and group C (3.8%). When using a final wound reduction in excess of 40% to distinguish healing from nonhealing ulcers, it was found that only the former present NIRS StO2 values abating over the study period both at center and edge of lesions. In conclusion, NIRS analysis of StO2 and wound area can predict the healing course of VLU. Adjunctive HBOT significantly facilitates VLU healing compared to the conventional treatment alone. This positive action, however, becomes manifest only with a longer and less intensive treatment schedule.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::71260f4064b4080057fa2d9bf40ecdf4 https://pubmed.ncbi.nlm.nih.gov/32789935 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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