Effects of Hyperbaric Oxygen Therapy on Impaired Wound Healing

Abstract
Several local and systemic factors may adversely affect wound healing leading to prolonged and incomplete healing. Treatment of chronic wounds in part based on definition and management of these factors. Hyperbaric oxygen therapy (HBO) is one of the important treatment approaches in chronic wounds. HBO therapy enhances collagen synthesis and maturation, fibroblast proliferation, epithelialization, increases leukocyte bacterial killing capacity and induces angiogenesis. HBO therapy also exerts antibacterial effect on selected microorganisms and reduces wound infection. Experimental studies also demonstrated that HBO therapy is beneficial in wounds impaired by drugs, such as octreotide and 5-fluorouracil, and stress. Further studies are needed in order to obtain a better understanding of the effects of HBO therapy on the basic mechanisms that are beneficial in wound healing and on those factors that impair wound healing.

Key words
hyperbaric oxygenation, wound management, chronic wound

Bibliografía del artículo
1. Phillips T, Stanton B, Provan A, Lew R. A study of the impact of leg ulcers on quality of life: financial, social, and psychologic implications. J Am Acad Dermatol 31:49-53, 1994.
2. Mustoe T. Understanding chronic wounds: a unifying hypothesis on their pathogenesis and implications for therapy. Am J Surg 187:65S-70S, 2004.
3. Feldmeier JJ. Hyperbaric Oxygen 2003: Indications and results, the Hyperbaric Oxygen Committee report. Edited by Feldmeier JJ. Kensington, MD: Undersea and Hyperbaric Medical Society, 2003.
4. Jain KK, Bozzuto TM, Neubauer V, Tao HY. Hyperbaric medicine around the world. In: Textbook of Hyperbaric Medicine, 4th revised edition. Edited by Jain KK. Göttingen, Germany: Hogrefe & Huber Publishers, pp. 459-464, 2004.
5. Tibbles PM, Edelsberg JS. Hyperbaric-oxygen therapy. N Engl J Med 334:1642-8, 1996.
6. Leach RM, Rees PJ, Wilmshurst P. Hyperbaric oxygen therapy. BMJ 317:1140-3, 1998.
7. Plafki C, Peters P, Almeling M, Welslau W, Busch R. Complications and side effects of hyperbaric oxygen therapy. Aviat Space Environ Med 71:119-24, 2000.
8. Clark JM, Lambertsen CJ. Pulmonary oxygen toxicity: a review. Pharmacol Rev 23:37-133, 1971.
9. Thorsen E, Aanderud L, Aasen TB. Effects of a standard hyperbaric oxygen treatment protocol on pulmonary function. Eur Respir J 12:1442-1445, 1998.
10. Evanger K, Haugen OH, Irgens A, Aanderud L, Thorsen E. Ocular refractive changes in patients receiving hyperbaric oxygen administered by oronasal mask or hood. Acta Ophthalmol Scand 82:449-53, 2004.
11. Davis JC, Hunt TK, editors. Problem Wounds. The role of oxygen. New York, Elsevier Science Publications, 1988.
12. Sheffield PJ. Tissue oxygen measurements. In: Davis JC, Hunt TK, editors, Problem Wounds. The role of oxygen. New York, Elsevier Science Publications pp. 17-51, 1988.
13. Tandara AA, Mustoe TA. Oxygen in wound healing--more than a nutrient. World J Surg 28:294-300, 2004.
14. Shweiki D, Itin A, Soffer D, Keshet E. Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis. Nature 359:843-5, 1992.
15. Siddiqui A, Galiano RD, Connors D, Gruskin E, Wu L, Mustoe TA. Differential effects of oxygen on human dermal fibroblasts: acute versus chronic hypoxia. Wound Repair and Regeneration 4:211-218, 1996.
16. Kivisaari J, Niinikoski J. Effects of hyperbaric oxygenation and prolonged hypoxia on the healing of open wounds. Acta Chir Scand 141:14-9, 1975.
17. Gimbel M, Hunt T. Wound healing and hyperbaric oxygenation. In: Kindwall EP, Whelan HT, editors. Hyperbaric medicine practice. 2nd ed.(rev) Flagstaff (AZ): Best Publishing Company pp. 169-204, 2002.
18. Kessler L, Bilbault P, Ortega F, et al. Hyperbaric oxygenation accelerates the healing rate of nonischemic chronic diabetic foot ulcers: a prospective randomized study. Diabetes Care 26:2378-82, 2003.
19. Sheikh AY, Gibson JJ, Rollins MD, Hopf HW, Hussain Z, Hunt TK. Effect of hyperoxia on vascular endothelial growth factor levels in a wound model. Arch Surg 135:1293-7, 2000.
20. Niklas A, Brock D, Schober R, Schulz A, Schneider D. Continuous measurements of cerebral tissue oxygen pressure during hyperbaric oxygenation--HBO effects on brain edema and necrosis after severe brain trauma in rabbits. J Neurol Sci 219:77-82, 2004.
21. Boykin JV Jr. Hyperbaric oxygen therapy: a physiological approach to selected problem wound healing. Wounds 8:183-198, 1996.
22. Faglia E, Favales F, Aldeghi A, et al. Adjunctive systemic hyperbaric oxygen therapy in treatment of severe prevalently ischemic diabetic foot ulcer. A randomized study. Diabetes Care 19:1338-43, 1996.
23. Siddiqui A, Davidson JD, Mustoe TA. Ischemic tissue oxygen capacitance after hyperbaric oxygen therapy: a new physiologic concept. Plast Reconstr Surg 99:148-55, 1997.
24. Mychaskiw G II, Pan J, Shah S, et al. Effects of hyperbaric oxygen on skin blood flow and tissue morphology following sciatic nerve constriction. Pain Physician 8:157-61, 2005.
25. Nylander G, Lewis D, Nordstrom H, Larsson J. Reduction of postischemic edema with hyperbaric oxygen. Plast Reconstr Surg 76:596-603, 1985.
26. Niinikoski JH. Clinical hyperbaric oxygen therapy, wound perfusion, and transcutaneous oximetry. World J Surg 28:307-11, 2004.
27. Jonsson K, Jensen JA, Goodson WH 3rd, et al. Tissue oxygenation, anemia, and perfusion in relation to wound healing in surgical patients. Ann Surg 214:605-13, 1991.
28. Hunt TK, Pai MP. The effect of varying ambient oxygen tensions on wound metabolism and collagen synthesis. Surg Gynecol Obstet 135:561-567, 1972.
29. Cardinale GJ, Udenfriend S. Prolyl hydroxylase. Adv Enzymol Relat Areas Mol Biol 41:245-300, 1974.
30. Hopf HW, Humphrey LM, Puzziferri N, West JM, Attinger CE, Hunt TK. Adjuncts to preparing wounds for closure: hyperbaric oxygen, growth factors, skin substitutes, negative pressure wound therapy (vacuum-assisted closure) Foot Ankle Clin 6:661-82, 2001.
31. Tompach PC, Lew D, Stoll JL. Cell response to hyperbaric oxygen treatment.Int J Oral Maxillofac Surg 26:82-6, 1997.
32. Kang TS, Gorti GK, Quan SY, Ho M, Koch RJ. Effect of hyperbaric oxygen on the growth factor profile of fibroblasts. Arch Facial Plast Surg 6:31-5, 2004.
33. Roberts GP, Harding KG. Stimulation of glycosaminoglycan synthesis in cultured fibroblasts by hyperbaric oxygen. Br J Dermatol 131:630-3, 1994.
34. Dimitrijevich SD, Paranjape S, Wilson JR, Gracy RW, Mills JG. Effect of hyperbaric oxygen on human skin cells in culture and in human dermal and skin equivalents. Wound Repair Regen 7:53-64, 1999.
35. Hopf HW, Gibson JJ, Angeles AP, et al. Hyperoxia and angiogenesis. Wound Repair Regen 13:558-64, 2005.
36. Sheikh AY, Rollins MD, Hopf HW, Hunt TK. Hyperoxia improves microvascular perfusion in a murine wound model. Wound Repair Regen 13:303-8, 2005.
37. Steed DL, Donohoe D, Webster MW, Lindsley L. Effect of extensive debridement and treatment on the healing of diabetic foot ulcers. Diabetic Study Group. J Am Coll Surg 183:61-64, 1996.
38. Travis J, Potempa J, Maeda H. Are bacterial proteinases pathogenic factors? Trends Microbiol 3:405-07, 1995.
39. Falanga V, Grinnell F, Gilchrest B, Maddox YT, Moshell A. Workshop on the pathogenesis of chronic wounds. J Invest Dermatol 102:125-27, 1994.
40. Cheadle WG. Risk factors for surgical site infection. Surg Infect (Larchmt) 7 Suppl 1:S7-11, 2006.
41. Hohn DC, MacKay RD, Halliday B, Hunt TK.. Effect of O2 tension on microbicidal function of leukocytes in wounds and in vitro. Surg Forum 27:18-20, 1976.
42. Allen DB, Maguire JJ, Mahdavian M, et al. Wound hypoxia and acidosis limit neutrophil bacterial killing mechanisms. Arch Surg 132:991-6, 1997.
43. Mader JT, Brown GL, Guckian JC, Wells CH, Reinarz JA. A mechanism for the amelioration by hyperbaric oxygen of experimental staphylococcal osteomyelitis in rabbits. J Infect Dis 142:915-22, 1980.
44. Park M. Effect of hyperbaric oxygen in infectious diseases: Basic mechanisms In: Kindwall EP, Whelan HT, eds., Hyperbaric Medicine Practice, 2nd revised edition, Flagstaff, AZ, Best Publishing Company pp. 205-243, 2002.
45. Hill GB, Osterhout S. Experimental effects of hyperbaric oxygen on selected clostridial species. II. In-vitro studies in mice. J Infect Dis 125:26-35, 1972.
46. Walden WC, Hentges DJ. Differential effects of oxygen and oxidation-reduction potential on the multiplication of three species of anaerobic intestinal bacteria. Appl Microbiol 30:781-5, 1975.
47. Kaye D. Effect of hyperbaric oxygen on Clostridia in vitro and in vivo. Proc Soc Exp Biol Med 124(2):360-6, 1967.
48. Demello FJ, Hashimoto T, Hitchcock CR, Haglin JJ. The effects of hyperbaric oxygen on germination and toxin production of Clostridium perfringens spores. In: Wada J, Iwa JT, eds: Proceedings of the Fourth International Congress on Hyperbaric Medicine. Baltimore, MD: Williams & Wilkins Co.; p. 276, 1970.
49. Farr SB, Touati D, Kogoma T. Effects of oxygen stress on membrane functions in Escherichia coli: role of HPI catalase. J Bacteriol 170:1837-42, 1988.
50. Hassan HM, Fridovich I. Superoxide radical and the oxygen enhancement of the toxicity of paraquat in Escherichia coli. J Biol Chem 253:8143-8, 1978.
51. Pakman LM. Inhibition of Pseudomonas aeruginosa by hyperbaric oxygen. I. Sulfonamide activity enhancement and reversal. Infect Immun 4:479-87, 1971.
52. Park MK, Muhvich KH, Myers RA, Marzella L. Hyperoxia prolongs the aminoglycoside-induced postantibiotic effect in Pseudomonas aeruginosa. Antimicrob Agents Chemother 35:691-5, 1991.
53. Muhvich KH, Park MK, Myers RA, Marzella L. Hyperoxia and the antimicrobial susceptibility of Escherichia coli and Pseudomonas aeruginosa. Antimicrob Agents Chemother 33:1526-30, 1989.
54. Mendel V, Reichert B, Simanowski HJ, Scholz HC. Therapy with hyperbaric oxygen and cefazolin for experimental osteomyelitis due to Staphylococcus aureus in rats. Undersea Hyperb Med 26:169-74, 1999.
55. Mendel V, Simanowski HJ, Scholz HCh. Synergy of HBO2 and a local antibiotic carrier for experimental osteomyelitis due to Staphylococcus aureus in rats. Undersea Hyperb Med 31:407-16, 2004.
56. Karukonda SR, Flynn TC, Boh EE, McBurney EI, Russo GG, Millikan LE. The effects of drugs on wound healing--part II. Specific classes of drugs and their effect on healing wounds. Int J Dermatol 39:321-33, 2000.
57. Yildiz S, Uluutku H, Gunay A, Yildirim I, Yildirim S, Gurbuz AK. The effect of hyperbaric oxygen therapy on the adverse effects of octreotide on wound healing. Eur J Gastroenterol Hepatol 16:475-8, 2004.
58. Erenoglu C, Uluutku H, Emeksiz S, Akin ML, Foley E, Celenk T. Effect of hyperbaric oxygen on anastomoses created under the influence of 5-FU. Undersea Hyperb Med 30:321-6, 2003.
59. Ezzat S. Pharmacological options in the treatment of acromegaly. Curr Opin Investig Drugs 6:1023-7, 2005.
60. Oberg K, Kvols L, Caplin M, et al. Consensus report on the use of somatostatin analogs for the management of neuroendocrine tumors of the gastroenteropancreatic system. Ann Oncol 15:966-73, 2004.
61. Turkcapar AG, Demirer S, Sengul N, et al. The adverse effects of octreotide on the healing of colonic anastomoses in rats. Surg Today 28:279-84, 1998.
62. Waddell BE, Calton WC Jr, Steinberg SR, Martindale RG. The adverse effects of octreotide on wound healing in rats. Am Surg 63:446-9, 1997.
63. Burroughs AK, McCormick PA, Hughes MD, Sprengers D, D'Heygere F, McIntrye N. Randomised, double-blind, placebo-controlled trial of somatostatin for variceal bleeding. Gastroenterology 99:1388-1395, 1990.
64. Mozell EJ, Woltering EA, O'Dorisio TM. Non-endocrine applications of somatostatin and octreotide acetate: facts and flights of fancy. Dis Month 37:751-848, 1991.
65. Longley DB, Harkin DP, Johnston PG. 5-fluorouracil: mechanisms of action and clinical strategies. Nat Rev Cancer 2003.
66. Bostanoglu S, Dincer S, Keskin A, Bostanoglu A, Dursun A, Serim C. Beneficial effect of Iloprost on impaired colonic anastomotic healing induced byintraperitoneal 5-fluorouracil infusion. Dis Colon Rectum 41:642-8, 1998.
67. Bozdag AD, Peker Y, Derici H, Gurkok C, Ozgonul M. The effect of preoperative 5-fluorouracil on colonic healing: an experimental study. Hepatogastroenterology 48:1631-4, 2001.
68. Rojas IG, Padgett DA, Sheridan JF, Marucha PT. Stress-induced susceptibility to bacterial infection during cutaneous wound healing. Brain Behav Immun 16:74-84, 2002.
69. Padgett DA, Marucha PT, Sheridan JF. Restraint stress slows cutaneous wound healing in mice. Brain Behav Immun 12:64-73, 1998.
70. Ebrecht M, Hextall J, Kirtley LG, Taylor A, Dyson M, Weinman J. Perceived stress and cortisol levels predict speed of wound healing in healthy male adults. Psychoneuroendocrinology 29:798-809, 2004.
71. Broadbent E, Petrie KJ, Alley PG, Booth RJ. Psychological stress impairs early wound repair following surgery. Psychosom Med 65:865-9, 2003.
72. Gajendrareddy PK, Sen CK, Horan MP, Marucha PT. Hyperbaric oxygen therapy ameliorates stress-impaired dermal wound healing. Brain Behav Immun 19:217-22, 2005.
73. Thom SR, Bhopale VM, Velazquez OC, Goldstein LJ, Thom LH, Buerk DG. Stem cell mobilization by hyperbaric oxygen. Am J Physiol Heart Circ Physiol 290:H1378-86, 2006.

Autoevaluación