SerenaGroup Research Foundation, Cambridge, MA, US.
Wound Care Clinic, Madigan Army Medical Center, WA, US.
J Wound Care. 2022 Mar 1;31(Sup3):S20-S24. doi: 10.12968/jowc.2022.31.Sup3.S20.
A growing body of evidence supports the use of topical oxygen therapy (TOT) in the treatment of diabetic foot ulcers (DFUs). In addition, anecdotal evidence suggests that topical oxygen may be effective in the treatment of other wound types. In May 2021, experts in the field of wound healing from across the US assembled in New Orleans for the inaugural Leaders in Wound Healing conference. In an interactive session dedicated to TOT, several physicians presented and debated the evidence for TOT. Experts in the audience also shared their experiences in treating patients with TOT. The consensus of the experts recommended the use of TOT in DFUs and supported payer reimbursement for the modality. However, they stressed the need for a guidance document on the use of TOT in patients with hard-to-heal wounds. Following the conference, a Delphi method was employed to establish consensus guidelines for prescribing TOT. A multidisciplinary panel of 24 wound experts (15 wound specialists, six vascular surgeons, one plastic surgeon, one critical care provider and one PhD researcher) participated in two rounds of questionnaires. The Delphi survey questions focused on the indications for topical oxygen, when to prescribe the therapy, pretreatment work-up, visit frequency and length of therapy. A clinical workflow algorithm was also included as part of the Delphi. After two rounds, the Delphi participants were able to reach consensus of >77% on when to prescribe topical oxygen, the wound types that may benefit from the therapy, pretreatment wound preparation and work-up and length of therapy. The goal of the guidelines is to standardise the use of topical oxygen and inform further research efforts.
越来越多的证据支持局部氧疗（TOT）在治疗糖尿病足溃疡（DFUs）中的应用。此外，一些传闻证据表明，局部氧疗可能对其他类型的伤口有效。2021 年 5 月，来自美国各地的伤口愈合领域专家齐聚新奥尔良，参加首届伤口愈合领袖会议。在专门讨论 TOT 的互动环节中，几位医生介绍并辩论了 TOT 的证据。观众中的专家还分享了他们使用 TOT 治疗患者的经验。专家们的共识建议在 DFUs 中使用 TOT，并支持为该治疗方式支付费用。然而，他们强调需要有一份关于 TOT 在治疗难愈性伤口患者中的使用指南。会议结束后，采用德尔菲法制定 TOT 处方指南的共识。一个由 24 名伤口专家组成的多学科小组（15 名伤口专家、6 名血管外科医生、1 名整形外科医生、1 名重症监护提供者和 1 名博士研究人员）参与了两轮问卷调查。德尔菲调查问题集中在局部氧的适应症、何时开处这种疗法、治疗前的检查、就诊频率和治疗时间。德尔菲还包括一个临床工作流程算法。经过两轮投票，德尔菲参与者在何时开处局部氧、可能从该治疗中获益的伤口类型、治疗前伤口准备和检查以及治疗时间等方面达成了 >77%的共识。该指南的目标是标准化局部氧疗的使用，并为进一步的研究工作提供信息。
