Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands & CIBEROBN (Physiopathology of Obesity and Nutrition), E-07122, Palma de Mallorca, Balearic Islands, Spain.
MEDISUB Recerca (Institut de Recerca Hiperbarica), Cami d´Aucanada 52, E-07410 Pto. de Alcudia, Balearic Islands, Spain.
Curr Pharm Des. 2019;25(15):1682-1693. doi: 10.2174/1381612825666190703162648.
Chronic and non-healing wounds, especially diabetic foot ulcers and radiation injuries, imply remarkable morbidity with a significant effect on the quality of life and a high sanitary cost. The management of these wounds requires complex actions such as surgical debris, antibiotic treatment, dressings and even revascularization. These wounds are characterized by poor oxygen supply resulting in inadequate oxygenation of the affected tissue. The adjuvant treatment with hyperbaric oxygen therapy (HBOT) may increase tissue oxygenation favoring the healing of wounds which do not respond to the usual clinical care. The increase in the partial pressure of oxygen contributes to cover the energy demands necessary for the healing process and reduces the incidence of infections. Moreover, the increase in oxygen leads to the production of reactive species with hormetic activity, acting on signaling pathways that modulate the synthesis of inflammation mediators, antioxidants and growth factors which can contribute to the healing process. Studies performed with cell cultures and in animal models seem to demonstrate the beneficial effects of HBOT. However, clinical trials do not show such conclusive results; thus, additional randomized placebo-controlled studies are necessary to determine the real efficacy of HBOT and the mechanism of action for various types of wounds.
慢性和非愈合性伤口，特别是糖尿病足溃疡和放射性损伤，意味着显著的发病率，对生活质量有重大影响，并带来高昂的卫生成本。这些伤口的治疗需要复杂的措施，如外科清创、抗生素治疗、敷料，甚至血管重建。这些伤口的特点是供氧不足，导致受影响组织的氧合不足。高压氧治疗（HBOT）的辅助治疗可以增加组织氧合，有利于通常的临床护理无法治疗的伤口愈合。氧分压的增加有助于满足愈合过程所需的能量需求，并降低感染的发生率。此外，氧气的增加会产生具有有益活性的活性氧物质，作用于信号通路，调节炎症介质、抗氧化剂和生长因子的合成，从而有助于愈合过程。细胞培养和动物模型的研究似乎表明 HBOT 具有有益的影响。然而，临床试验并没有显示出如此确凿的结果；因此，需要进行更多的随机安慰剂对照研究，以确定 HBOT 的真正疗效和各种类型伤口的作用机制。
