Hyperbaric Oxygen Therapy: Solution for Difficult to Heal Acute Wounds? Systematic Review.
Summary of "Hyperbaric Oxygen Therapy: Solution for Difficult to Heal Acute Wounds? Systematic Review."
BACKGROUND:
Hyperbaric oxygen therapy (HBOT) is used to treat various wound types. However, the possible beneficial and harmful effects of HBOT for acute wounds are unclear.
METHODS:
We undertook a systematic review to evaluate the effectiveness of HBOT compared to other interventions on wound healing and adverse effects in patients with acute wounds. To detect all available randomized controlled trials (RCTs) we searched five relevant databases up to March 2010. Trial selection, quality assessment, data extraction, and data synthesis were conducted by two of the authors independently.
RESULTS:
We included five trials, totaling 360 patients. These trials, with some methodologic flaws, included different kinds of wound and focused on different outcome parameters, which prohibited meta-analysis. A French trial (n = 36 patients) reported that significantly more crush wounds healed with HBOT than with sham HBOT [relative risk (RR) 1.70, 95% confidence interval (CI) 1.11-2.61]. Moreover, there were significantly fewer additional surgical procedures required with HBOT (RR 1.60, 95% CI 1.03-2.50), and there was significantly less tissue necrosis (RR 1.70, 95% CI 1.11-2.61). In one of two American trials (n = 141) burn wounds healed significantly quicker with HBOT (P < 0.005) than with routine burn care. A British trial (n = 48) compared HBOT with usual care. HBOT resulted in a significantly higher percentage of healthy graft area in split skin grafts (RR 3.50, 95% CI 1.35-9.11). In a Chinese trial (n = 145) HBOT did not significantly improve flap survival in patients with limb skin defects.
CONCLUSIONS:
HBOT, if readily available, appears effective for the management of acute, difficult to heal wounds.
Affiliation
Department of Quality Assurance & Process Innovation, Room A3-503, Academic Medical Center, University of Amsterdam, Meibergdreef 9, P.O. Box 22700, Amsterdam, 1100 DE, The Netherlands.
Journal Details
This article was published in the following journal.
Name: World journal of surgery
ISSN: 1432-2323
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21184071
- DOI: http://dx.doi.org/10.1007/s00268-010-0923-4
Medical and Biotech [MESH] Definitions
Hyperbaric Oxygenation
The therapeutic intermittent administration of oxygen in a chamber at greater than sea-level atmospheric pressures (three atmospheres). It is considered effective treatment for air and gas embolisms, smoke inhalation, acute carbon monoxide poisoning, caisson disease, clostridial gangrene, etc. (From Segen, Dictionary of Modern Medicine, 1992). The list of treatment modalities includes stroke.
Fissure In Ano
A painful linear ulcer at the margin of the anus. It appears as a crack or slit in the mucous membrane of the anus and is very painful and difficult to heal. (Dorland, 27th ed & Stedman, 25th ed)
Head Injuries, Penetrating
Head injuries which feature compromise of the skull and dura mater. These may result from gunshot wounds (WOUNDS, GUNSHOT), stab wounds (WOUNDS, STAB), and other forms of trauma.
Saline Solution, Hypertonic
Hypertonic sodium chloride solution. A solution having an osmotic pressure greater than that of physiologic salt solution (0.9 g NaCl in 100 ml purified water).
Wounds, Stab
Penetrating wounds caused by a pointed object.
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