Abheilung chronischer Wunden an einem Unterschenkel durch Hämoglobinspray und Regeneration einer begleitenden Dermatoliposklerose durch intermittierte normobare Sauerstoff-Inhalationen (INBOI): ein Fallbericht
| Autor: | Barnikol, Wolfgang K. R., Pötzschke, Harald |
|---|---|
| Jazyk: | němčina |
| Rok vydání: | 2010 |
| Předmět: |
Male
tcPO2 als Maß für den Gewebe-PO2 Administration Topical kontrollierte Erhaltungsbehandlung 2 phases of skin regeneration metabolische und zelluläre Hautregeneration dermatoliposclerosis lcsh:Medicine healing of chronic wounds Hypoxie der Haut als Ursache chronischer Wunden Severity of Illness Index Hemoglobins Scleroderma Localized Gewebe-Regeneration Hemo2spray® low skin tcPO2 as indicator for chronic wounds intermittierte normobare Sauerstoff-Inhalation (INBOI) PO2 inhomogeneity arterielle Okklusion kontrollierte Wundprophylaxe Leg Ulcer Remission Induction tcPO2 as a measure of the tissue PO2 2 Phasen der Haut-Regeneration PO2-Inhomogenität 610 Medical sciences Medicine Combined Modality Therapy kontrollierte Rehabilitation Atmospheric Pressure ddc: 610 mikro-vaskuläre (kapilläre) Regeneration metabolic and cellular skin regeneration chronische Wunden arterial occlusion microvascular (capillary) regeneration geringer tcPO2 als Indikator für die Bildung chronischer Wunden maintaining treatment with oxygen Gewebe-PO2 als entscheidende Größe für die zelluläre Sauerstoff-Versorgung Sauerstoff-Substitution tissue regeneration peri-ulzeraler Sauerstoffpartialdruck oxygen substitution Sauerstoff-Toxizität Article oxygen toxicity peri-ulceral oxygen partial pressure controlled rehabilitation Dermatoliposklerose Hämoglobin Humans Regeneration Aged Wound Healing lcsh:R Oxygen Inhalation Therapy intermittent normobaric oxygen inhalation (INBOI) haemoglobin hypoxia of the skin as reason for chronic wounds chronic wounds Chronic Disease tissue PO2 as decisive quantity for the cellular oxygen supply controlled wound prophylaxis Heilung chronischer Wunden |
| Zdroj: | GMS German Medical Science GMS German Medical Science, Vol 9, p Doc08 (2011) GMS German Medical Science; VOL: 9; DOC08 /20110330/ |
| ISSN: | 1612-3174 |
| Popis: | A new healing procedure has been developed on the basis of the successful treatment of therapy-resistant hypoxic (and practically anoxic) leg ulcerations located within a heavy dermatoliposclerosis. The procedure involves an initial intra-ulceral application of haemoglobin followed by the intermittent administration of normobaric oxygen via inhalation. Haemoglobin is capable of externally supplying the granulating wound bed with oxygen at low partial pressure in a physiological manner, like a micro lung, so that oxidative stress can be avoided. A long-term daily administration of oxygen from within – including the peri-ulceral skin – is achieved by intermittent normobaric oxygen inhalation (INBOI) regularly throughout the day in the form of 1-hour sessions. Using this combined healing treatment during haemoglobin applications the ulcerations healed within about 1 month, and subsequently with INBOI therapy within further approx. 4 months the peri-ulceral skin regenerated as far as the oxygenation status was concerned: The peri-ulceral transcutaneous oxygen partial pressure (tcPO2) of zero (measured during breathing of normal air) rose to a satisfactory value of approx. 35 mmHg. After 28 months of treatment, the completely hypoxic and degenerated skin on the leg had practically returned to normal with a PO2 of 45 mmHg. Furthermore, the skin dermatoliposclerosis regressed. The skin regeneration was long-lasting, which was probably related to cellular tissue regeneration with an increase in the capillary density, whereby it had to be maintained by regular oxygen inhalation (INBOI maintaining treatment). By unintended intra-individual therapy variations it is evidenced that local hypoxia was the reason for skin degeneration: 3 x 1 h oxygen inhalation were sufficient for the healing treatment; 2 x 1 h sufficed for maintenance, whereas 2 x 0.5 h did not. The new procedure carries practically no risks, is simple, cheap and effective. Whereas the application of haemoglobin requires professional supervision, the oxygen inhalation can be carried out at home following initial guidance and monitoring by a physician. Using this novel method, the therapy-resistant ulceration could be closed within 5 months, during which daily outpatient care was only necessary for 1 month. The successful outcome of the treatment in terms of improvement of oxygen supply can monitored at any time using peri-ulceral tcPO2 measurements, whereby, due to the inhomogeneity of the values, measurements at a minimum of two locations at the wound edge are strongly recommended and more measurements at more skin locations would be preferable. Besides its use in the healing of ulcers, the new procedure is also suitable for the prevention of ulceration development (prophylactic INBOI treatment) in skin rendered susceptible due to the presence of hypoxia. Here, peri-ulceral transcutaneous oxygen partial pressures of below 10 mmHg should be considered as being critical and are an indication for a prophylactic oxygen inhalation treatment. The new procedure may also be suitable even before the peri-ulceral oxygen partial pressure falls below 10 mmHg. Four measures for rehabilitation, conservation, and prevention with regard to a healed chronic wound are proposed. GMS German Medical Science; 9:Doc08; ISSN 1612-3174 |
| Databáze: | OpenAIRE |
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