Christopher Japour1, Edward Chen2, Michael Griffiths3
1VA Medical Center Northport (Northport, United States)
2VA Medical Center Danville (Danville, United States)
3AOTI (Oceanside, United States)
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EWMA 2013 - Ep585 - Topical Oxygen used with Standard Best Practice Wound Care on Recalcitrant Diabetic Ulcers
1. Christopher Japour1, Edward Chen2, Michael Griffiths3
1VA Medical Center Northport (Northport, United States)
2VA Medical Center Danville (Danville, United States)
3AOTI (Oceanside, United States)
2. Physiologically oxygen is involved with leucocyte regulation, the
enzymatic production of collagen and is therefore important in
many phases of wound healing, that includes both angiogenesis
and formation of granulation tissue.
Adequate delivery
of oxygen to the
ulcer tissue is
vital for healing
to occur
Adapted from C. Sen -
Wound Healing Essentials
Let There Be Oxygen.
Wound Repair Reg - 2008
Oxygen
metabolites
3. Patients in this study had diabetic
foot ulcers recalcitrant to
standard best practice wound
care for four weeks or greater.
The Topical Wound Oxygen
therapy was applied by the
patient at home for 90 minutes
daily 7 days /week.
The Topical Wound Oxygen
System delivered 100% oxygen to
the wound bed utilizing pressure
cycles between 5mbar and
50mbar.
Topical Wound Oxygen
Therapy System
4.
5. During the treatment period, all patients received
current standard best practice wound care, including:
infection control
debridement of devitalized tissue either enzymatically
or via sharp debridement
offloading and/or compression therapy
plus the addition of topical pressurized oxygen
therapy
Foot dressings were not disturbed for treatments as
oxygen permeable dressings were used.
6. All patients were male with an average age of 57.
Prior to treatment the non-healing ulcers averaged 3.13
cm2 (0.08 - 4.90 cm2) in area and either extended deep to
the subcutaneous tissue (3/5), deep to the bone (1/5) or
deep to the tendon (1/5).
Wound closure was achieved on all ulcers.
These ulcers were recalcitrant to standard practice wound
care for an average of 15.6 months.
The average ulcer time to closure using topical oxygen was
3.4 months (1 month - 6 months) and average number of
treatments to closure at 45 (10 - 105).
7.
8. We have found that the addition of topical oxygen in
treating recalcitrant pedal ulcers enhances their healing
and all ulcers in the study closed.
Further randomized controlled trials are needed to fully
validate the effectiveness of this promising modality.