Department of Surgery, Hyperbaric Medicine, Amsterdam UMC, Location Academic Medical Center (AMC), University of Amsterdam (UVA), Amsterdam, The Netherlands.
Hyperbaar Geneeskundig Centrum, Rijswijk, The Netherlands.
Wound Repair Regen. 2021 Mar;29(2):254-260. doi: 10.1111/wrr.12884. Epub 2020 Dec 30.
The present article evaluates the results of the treatment with adjuvant hyperbaric oxygen therapy (HBOT) of patients with nonhealing, chronic wounds. In the period 2013 to 2016, 248 patients were referred from various hospitals because of chronic wounds that were recalcitrant in healing despite standard wound care as described in national and international guidelines. After inclusion, all patients were treated with HBOT and subjected to a weekly standard wound care treatment. During each HBOT session, 100% O was administered for 75 minutes under increased pressure of 2.4 ATA. Wounds and quality of life were assessed before and after the total treatment period. A total of 248 patients have been evaluated. Diabetic foot ulcers were present in 134 patients, the remainder (114 patients) showed a variety of wound locations and etiologies. The number of HBOT treatments amounted to an average of 48 (range 20-68) sessions. Before referral to our clinic, 31% of all wounds had existed for at least 18 months (72 patients). After HBOT, 81% of all wounds were near complete healing or completely healed, in 13% of the cases the wound was stable, and in 2% minor or major amputation had to be carried out. The mean treatment time for wounds pre-existing fewer than 6 weeks ("early referrals") was 67 days, and 119 days for wounds pre-existing more than 18 months ("late referrals"). A majority of the patients in our study referred with nonhealing wounds clinically improved when adjuvant HBOT was added to standard wound care protocols. No differences in success rate were seen between diabetic and nondiabetic wounds. It showed that HBOT is a well-tolerated treatment.
本文评估了辅助高压氧治疗（HBOT）治疗非愈合性慢性伤口患者的结果。在 2013 年至 2016 年期间，由于慢性伤口尽管按照国家和国际指南中描述的标准伤口护理方法仍难以愈合，因此从多家医院转诊了 248 名患者。纳入后，所有患者均接受 HBOT 治疗，并接受每周一次的标准伤口护理治疗。在每次 HBOT 治疗中，在 2.4 ATA 的增加压力下，以 100%的 O2 治疗 75 分钟。在整个治疗期间前后评估伤口和生活质量。共评估了 248 名患者。134 名患者患有糖尿病足溃疡，其余（114 名）患者表现出各种伤口位置和病因。HBOT 治疗次数平均为 48 次（范围为 20-68 次）。在转诊到我们的诊所之前，所有伤口中有 31%至少存在 18 个月（72 名患者）。HBOT 后，所有伤口中有 81%接近完全愈合或完全愈合，13%的病例伤口稳定，2%的病例需要进行小或大截肢。现存少于 6 周（“早期转诊”）的伤口的平均治疗时间为 67 天，现存超过 18 个月（“晚期转诊”）的伤口的平均治疗时间为 119 天。在我们的研究中，大多数转诊患者在添加标准伤口护理方案的辅助 HBOT 后，其慢性伤口的临床状况得到改善。糖尿病和非糖尿病伤口的成功率无差异。这表明 HBOT 是一种耐受良好的治疗方法。
