Breath of Fresh Air for Hard-to-Heal Wounds

Topical oxygen therapy is an effective treatment

WEDNESDAY, Jan. 29, 2003 (HealthDayNews) -- A simple, economical way to treat chronic and other hard-to-heal wounds may be in the bag.

Ohio State University surgical scientists say they've had success using a specially designed bag called a "topical hyperbaric oxygen chamber." The researchers found that using the chamber to treat wounds with pure oxygen for brief intervals helped problem wounds to heal better and faster.

The researchers' study, in the current issue of the journal Pathophysiology, examined results from 30 people with 56 wounds, including post-surgical wounds, acute trauma injuries, diabetic ulcers, and bedsores.

The people in the study included some whose wounds didn't heal with standard treatments such as wound-care creams or stitches.

The topical oxygen chamber -- an inflatable, clear plastic bag -- was positioned around the wound area or around a limb with a wound. The bag was secured using medical-grade adhesive. Pure oxygen was pumped into the bag for 90 minutes a day for four days. That was followed by a three-day rest period, the researchers say.

The length of treatment varied for different patients, ranging from 24 days to eight months. The topical oxygen therapy was done in a hospital, extended care facilities, and the study subjects' homes.

The study found that about three-quarters of the wounds healed after topical oxygen therapy.

"What we reported is that we are seeing roughly a 75 percent success rate in these very difficult wounds," says study lead author Chandan Sen, associate director of the Davis Heart and Lung Research Institute at Ohio State University.

The best healing rates were in acute trauma (75 percent) and postsurgical (100 percent) wounds on the trunk, arms, and hands. Half of all acute wounds on the hands and feet healed, the study says.

Chronic wounds that had good healing rates included venous stasis ulcers on the leg (92 percent) and diabetic hand ulcers (91 percent).

Some wounds didn't respond as well. For example, bedsores had a 44 percent healing rate when treated with topical oxygen therapy.

Sen says topical oxygen therapy may not be sufficient to fully heal bedsores and wounds on the lower extremities. But he says it may be helpful in such cases when used with other kinds of standard wound care.

He says oxygen is an important factor in wound healing, but the very nature of a major acute or chronic wound can limit the amount of oxygen available to help healing.

"One of the basic characteristic features of a wound is disruption of blood vessels. They get torn," Sen says.

"So what happens is the area that is injured does not get enough blood supply. This means it does not get enough oxygen supply. So hypoxia [low oxygen] is a characteristic feature and a major limiting factor in wound healing," Sen says.

He notes that he's referring to serious, difficult-to-heal wounds, not your everyday nicks and cuts.

Large hyperbaric chambers are often used to improve oxygen supply to difficult and dangerous wounds. These are the same chambers used to treat divers who suffer decompression sickness, also called "the bends."

But these large chambers have a number of drawbacks, Sen says. They're not available everywhere, they can help only a few people at a time, they're expensive, and they require specialized staff.

The topical oxygen chambers are much less expensive, easy to use, and highly portable. For example, they can be used at home and could be used to treat soldiers on the battlefield or to treat disaster-related casualties, Sen says.

Topical oxygen chambers have U.S. Food and Drug Administration approval and are sold by a number of manufacturers. For this study, Sen and his colleagues had a topical chamber manufactured to their specifications.

Dr. Stan Nahman, a professor of internal medicine at Ohio State who was not involved in the study, says the topical chambers are a "clever way of administering local, high-dose oxygen to tissue that needs it."

He agrees that topical oxygen therapy has a number of advantages over the large, hyperbaric chambers.

"You could see this becoming a fairly common ancillary care kind of tool. They can be developed and used fairly cheaply," Nahman says.

More information

Here's where you can learn more about how wounds heal. And check this story from the Herald-Leader of Lexington, Ky., on hyperbaric chambers.

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