What is Hyperbaric Oxygen Wound Therapy and How Does it Benefit Patients?
Chronic non-healing wounds such as diabetic foot ulcers and venous insufficiency ulcers remain in the inflammatory state despite adequate management, prolonging wound healing, and adversely affecting the quality of life of patients. While pathologies vary, one of the most frequent causes is hypoxic (low-oxygenated) wound tissues in the wound bed. Hyperbaric oxygen wound therapy (HBOT) has gained attention as a viable procedure for treating select wounds in the medical community for many years. This article will examine the procedure, benefits, limitations, and contraindications of HBOT in managing chronic wounds.
What is HBOT?
Hyperbaric oxygen wound therapy is a wound management technique where a patient's body is exposed to 100% oxygen at a pressure higher than atmospheric pressure for a short period. It improves oxygenation in chronic wounds where other methods fail, thus increasing the rate of wound healing. Adequate and timely treatment of chronic wounds using HBOT may also help to prevent the need for partial or total lower limb amputation.
Hyperbaric oxygen wound therapy is administered inside a chamber subjected to significantly higher pressures than atmospheric pressure. According to Henry’s law, the quantity of oxygen from the immediate environment that dissolves in the blood or body tissue is proportional to the partial pressure. Thus, hyperbaric conditions can increase the amount of oxygen available in skin tissues, which is critical for wound healing.
Hyperbaric chambers are typically monoplace or multi-place tubes up to 7 feet long fitted with a hood or mask that allows a patient to breathe 100% oxygen intermittently while the rest of the body (including wounds) is exposed. The chamber is subsequently pressurized to 2.5 or 3 times the atmospheric pressure between 30 minutes and 2 hours and slowly depressurized. Depending on the nature and severity of the wound, the treatment may be administered more than once a day.
The primary mechanisms of action in HBOT are hyperoxygenation and reduction of bubble size. An increase in the amount of dissolved oxygen in the wound bed results in a corresponding increase in collagen synthesis and fibroblast proliferation. A reduction in the bubble size due to increased pressure in the hyperbaric chamber aids the management of decompression sickness in patients. Secondary mechanisms include angiogenesis, inhibition of toxins, vasoconstriction, and increasing free radical formation.
Benefits of HBOT
HBOT has been established as a viable technique for treating chronic wounds where other methods fail. HBOT can be administered to manage the following wound types:
Diabetic foot ulcers, venous insufficiency ulcers, and other ischemic wounds
When used in treating chronic wounds such as diabetic foot ulcers and venous ulcers, HBOT increases the rate of wound healing by improving angiogenesis and stimulating growth factors, notably the vascular endothelial growth factor (VEGF). HBOT is usually administered alongside other wound management techniques such as dressings, pressure relief, infection control, debridement, and nutrition.
Compromised skin grafts and flaps
In compromised skin grafts and flaps, HBOT facilitates wound healing by inducing hyperoxia in the wound bed as well as enhancing leukocyte function, angiogenesis, and antimicrobial action. Further, HBOT improves oxygenation in the grafts to improve survival and induces fibroblast proliferation and collagen synthesis in compromised flaps.
Necrotizing soft tissue infections and radiation-induced wounds
For treating infected wounds such as necrotizing soft tissues and clostridial myonecrosis, HBOT induces antimicrobial action by inhibiting the production of toxins through the production of oxidative free radicals. HBOT will be typically administered alongside surgical debridement and antibiotics for infection control. In radiation-induced wounds, HBOT improves oxygenation in the irradiated tissues and also acts as a catalytic factor for angiogenesis.
Contraindications of HBOT
Despite numerous benefits for promoting wound healing in chronic wounds, HBOT has several side effects and may result in complications in patients. Common side effects and complications post-therapy include myopia, lung damage, rupture of the middle ear, decompression sickness, seizures, aggravation of existing cataracts, and hypoglycemia. Barotrauma (pressure-induced injuries), in particular, result from the body’s inability to equalize pressure from the chamber with the surrounding environment for a period after the procedure. Tissue related injury occurs due to excessive shear force induced by the expansion of gas within the chamber, or pressure hydrostatic pressure transmission through tissue. In most cases, however, HBOT side effects will resolve on their own anywhere from a few days to weeks.
Exercise Routines for Health and Fitness: Moderate and High-intensity Workouts
There are different types of exercises; you get better results when you choose a combination of activities that cater to your needs. Research shows that you can gain tremendous benefits by doing a mix of four types of exercise: endurance activities, strength training.
Foam Dressings: Benefits And Applications
Non-adhesive foam dressings require the use of an additional secondary dressing to be secured in position. In general, thin foam dressings have an adhesive wound contact layer.
Hydrogel Wound Dressings: Benefits And Applications
Hydrogel wound dressings belong to the class of modern wound dressings that actively stimulate the wound healing process. They are composed of synthetic polymers with a high water content formed in the shape of sheets, amorphous gels, and foams.
Alginate Wound Dressings: Benefits And Applications
In the United States, approximately 6 million people are affected by chronic wounds. The number is only expected to increase with the rise in the elderly population. Wound dressings form an essential component of wound care.
How Obesity and Overweight Affects Wound Healing
Obesity and excessive weight are conditions that continue to disproportionately affect Black and African American people in the United States.
Understanding and Tackling Hypertension in African American Communities
Hypertension, also known as high blood pressure, is more prevalent in African American communities than in other racial groups in the United States. A Centers for Disease Control and Prevention (CDC) report indicated that about 5 in 10 non-Hispanic Black adults are hypertensive.
Understanding the Risk Factors for Pressure Ulcers
Pressure ulcers, also called bedsores or decubitus ulcers, are areas of localized damage to the skin and underlying tissue. They result from unrelieved pressure on the skin, friction, shear, or a combination of these.
The Role of Artificial Intelligence in Amputation Prevention
With the various technological advancements, amputation prevention through proper wound care is an attractive area for Artificial Intelligence (AI). In 2002, the whole world was in awe when Google brain, an Artificial Intelligence research team, could find a cat in a YouTube video.
The Role of Advanced Biologics (Skin Substitutes) in Wound Healing
For a long time now, limb amputation has affected the mobility of African Americans living with chronic diseases. Worse still, studies have shown that limb amputation among diabetes
Know Better, Do Better: Adopting Healthy Lifestyles for Amputation Prevention
Black Americans are twice as likely to develop pulmonary artery disease (PAD) – a leading cause of lower limb amputation – as any other race.
Tackling the Education Gap: Encouraging Medical Careers Among Black Students
Black and African American doctors make up 5% of all active physicians in the country – a mere 45,534 healthcare professionals. With the African American population at about 46.9 million, it is clear why Black communities are underserved.
The Amputation Epidemic in Black America: What Everyone Needs to Know
Peer-reviewed studies have revealed that black patients are three times more likely to lose limbs than the national average. In black populated areas with little or no access to quality healthcare...
Why Are Black People Losing Limbs More Often?
Now more than ever, Blacks and African Americans are losing lower extremity limbs. In recent years, there has been a stark difference in the amputation rates in Black and white communities.
Peripheral Arterial Disease (PAD) and Its Impact On Wound Care
Peripheral Artery Disease (PAD) is the narrowing of the arteries in the arms, legs, and internal organs. It’s often caused by atherosclerosis which is the buildup of fat and cholesterol – called plaque – in the arteries.
Promoting Physical Exercise and Mobility in African American Communities
Inadequate physical inactivity has increasingly been recognized as a leading cause of mobility problems and early mortality in the world.
A Spotlight on Healthcare Disparities in African American Communities
Even with promising interventions such as the enactment of the Affordable Care Act, healthcare equality in the U.S. seems like a distant goal. African Americans are still more likely to be burdened with chronic diseases
Avenues for Promoting Health Awareness in African Communities
Disparities in healthcare remain a serious problem in African American communities. The history of slavery and other social determinants like systemic racism and access to healthy foods undoubtedly underlie the inexcusably poor state of African American health.
The State of Black Health in America
Over 150 years from the abolishment of slavery, healthcare in America is stilled marred by systemic racial discrimination and inequality. According to the CDC, 20.2 percent of black American adults are living in fair or poor health. This is a visibly higher population compared to white, non-Hispanic (14.1 percent).
Black Nutrition: Are You Eating The Right Diet?
Blacks have dietary preferences born from cultural influence. A study conducted on 7,000 men and women over 45 years living across the U.S. found that Black participants were more likely to eat a diet comprising highly processed foods compared to their White counterparts. Further, 46% of Blacks and 33% of Whites developed hypertension, with diet being the reason for much of the disparity.
Debridement: A Critical Component of Wound Treatment
Debridement is a part of the standard DIME technique for wound bed preparation in chronic wounds.
What is Negative Pressure Wound Therapy and How Does it Benefit Patients?
Negative Pressure Wound Therapy (NPWT) aims to facilitate wound healing by modifying the pressure over a wound surface.
The Benefits of Telemedicine To Wound Care
Telemedicine is particularly beneficial in long-term care facilities where a significant number of Americans living with chronic conditions such as non-healing wounds reside.
Why are Some Wounds Slow To Heal?
Chronic slow-healing wounds are those that fail to progress through a timely and predictable sequence of repair.
What is Hyperbaric Oxygen Wound Therapy and How Does it Benefit Patients?
Chronic non-healing wounds such as diabetic foot ulcers and venous insufficiency ulcers remain in the inflammatory state despite adequate management, prolonging wound healing, and adversely affecting the quality of life of patients.
Diagnosis and Management of Pressure Ulcers
Leading research estimates a prevalence of up to 27% of pressure ulcers in patients living at long-term care facilities. Elderly patients (above 70 years of age), obese patients, patients with limited mobility, and those with underlying medical conditions e.g., peripheral arterial disease, and multiple sclerosis are the most at risk of developing pressure ulcers.
Compression Therapy for Wound Management
For patients living with chronic wounds such as venous ulcers, compression therapy can help to ease symptoms and aid wound healing.
Democratizing Wound Care in Hospice Care Facilities
Hospice care facilities provide care for the terminally ill, including patients battling late-stage cancer, heart disease, and kidney failure, as well as those living with chronic non-healing wounds.
Dealing With Diabetic Foot Ulcers During The Pandemic
People living with diabetes represent a subset of individuals with special health needs due to the nature of the disease.
What Clinicians Need To Know About Wound Care Dressings
To healthcare experts, choosing the right dressing is critical to improving wound healing outcomes in patients.