Shoshani O, Shupak A, Barak A, Ullman Y, Ramon Y, Lindenbaum E, Peled Y
Israel Naval Medical Institute, IDF Medical Corps, Department of Plastic Surgery, Rambam Medical Center, Haifa, Israel.
Br J Plast Surg. 1998 Jan;51(1):67-73. doi: 10.1054/bjps.1997.0060.
Most previous animal studies reporting improved epithelialisation and healing of burn wounds under hyperbaric oxygen (HBO) did not include the conventional treatment with topical antibiotics as part of the protocol, and did not compare the effectiveness of HBO therapy with that of normobaric 100% oxygen (NO). The purpose of our study was to compare the results of combined treatment with HBO + silver sulfadiazine (SS) and those of treatment with NO + SS or SS alone. Deep second degree burns were produced on the depilated backs of 54 guinea pigs using a validated burn protocol. The animals were assigned to three treatment groups: HBO + SS, NO + SS, and SS. Dressings were changed daily. HBO was administered at 2 atmospheres absolute (ATA) for 90 min BID, and NO for 90 min BID. The parameters compared among the groups were laser Doppler flowmetry, and burn wound contracture and re-epithelialisation data derived from computerised planimetry of photographs of the wound. No differences in laser Doppler flowmetry results or the magnitude of contracture were found between the groups. Significantly increased re-epithelialisation was observed under NO + SS starting 10 days after the burn (P = 0.02, ANOVA). This significance stems from the difference between the HBO + SS and NO + SS groups (Tukey test). These data indicate that excessively high levels of tissue PO2 might compromise burn healing, and explain our results. A further study comparing combined treatment using a milder HBO protocol + SS and NO + SS is indicated in the search for the optimal HBO regimen.
以往大多数关于高压氧（HBO）可改善烧伤创面上皮化和愈合的动物研究，并未将局部使用抗生素的传统治疗作为方案的一部分，也未将HBO疗法与常压100%氧气（NO）疗法的效果进行比较。我们研究的目的是比较HBO联合磺胺嘧啶银（SS）治疗、NO联合SS治疗或单独使用SS治疗的结果。采用经过验证的烧伤方案，在54只豚鼠脱毛的背部造成深二度烧伤。将动物分为三个治疗组：HBO + SS组、NO + SS组和SS组。每天更换敷料。HBO以2个绝对大气压（ATA）给药，每次90分钟，每日两次；NO每次给药90分钟，每日两次。比较各组之间的参数包括激光多普勒血流仪测量结果，以及通过伤口照片计算机化平面测量得出的烧伤创面挛缩和再上皮化数据。各组之间在激光多普勒血流仪测量结果或挛缩程度方面未发现差异。在烧伤后10天开始观察到，NO + SS组的再上皮化显著增加（P = 0.02，方差分析）。这种显著性源于HBO + SS组和NO + SS组之间的差异（Tukey检验）。这些数据表明，过高的组织PO2水平可能会损害烧伤愈合，并解释了我们的研究结果。在寻找最佳HBO治疗方案时，需要进一步研究比较使用较温和的HBO方案联合SS与NO + SS的联合治疗效果。
