Improvement of ischemic non-healing wounds following hyperoxygenation: the experience at Rambam-Elisha Hyperbaric Center in Israel, 1998-2007.

BACKGROUND

Wounds of the lower extremities are a significant public health problem, being severe and costly to treat. Adjunctive treatment with hyperbaric oxygenation (HBOT) has proven to be a useful and cost-effective means of treating ischemic wounds, mainly in diabetic patients.

OBJECTIVES

To describe patients with ischemic wounds treated at the Rambam and Elisha Hyperbaric Medical Center and their wound improvement following HBOT.

METHODS

We conducted a retrospective cohort study of all patients (N = 385) treated in the center during 1998-2007 for ischemic non-healing wounds in the lower extremities.

RESULTS

The mean age of the patients was 61.9 years (SD 13.97). Most of them were diabetic (69.6%) and male (68.8%). Half of the subjects had a wound for more than 3 months prior to undergoing pre-HBOT transcutaneous oximetry (TcPO2) testing. Most of the wounds were classified as Wagner degree 1 or 2 (39.1% and 46.2% respectively). The median number of treatments per patient was 29. Only 63.1% of patients had continuous treatments. Approximately 20% of patients experienced mild side effects. An improvement occurred in 282 patients (77.7%) following HBOT: 15.2% fully recovered, 42.7% showed a significant improvement (and were expected to heal spontaneously), and 19.8% a slight improvement.

CONCLUSIONS

HBOT can benefit the treatment of non-healing ischemic wounds (especially when aided by pretreatment TcPO2 evaluation; data not shown). Our experience shows that this procedure is safe and contributes to wound healing.