Hyperbaric Oxygen Therapy: Solution for Difficult to Heal Acute Wounds? Systematic Review

Anne M. Eskes, Dirk T. Ubbink, Maarten J. Lubbers, Cees Lucas, Hester Vermeulen

Research output: Contribution to journalArticleAcademicpeer-review

32 Citations (Scopus)
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Abstract

BackgroundHyperbaric oxygen therapy (HBOT) is used to treat various wound types. However, the possible beneficial and harmful effects of HBOT for acute wounds are unclear.
MethodsWe 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.

ResultsWe 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.
ConclusionsHBOT, if readily available, appears effective for the management of acute, difficult to heal wounds.
Original languageEnglish
Pages (from-to)535-542
JournalWorld journal of surgery
Volume35
Issue number3
DOIs
Publication statusPublished - Mar 2011

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