Granulox—The Use of Topical Hemoglobin to Aid Wound Healing: A Literature Review and Case Series From Singapore

Natrox™ topical oxygen therapy (TOT) ( Inotec AMD Ltd, Cambridgeshire, UK) employs a small battery-powered “oxygen generator” to concentrate atmospheric oxygen and feeds pure, moist, oxygen through a fine, soft tube to a dressing-like “oxygen distribution system”, which is placed over the wound and is held in place by a conventional dressing. The aim was to determine the effectiveness of Natrox™ for non-healing diabetic foot ulcers (DFU) over a 3-month period.Longitudinal, single-arm, open prospective registry study using 12 weeks of TOT using a 4 week run-in period. 20 patients recruited to OTONAL had chronic DFU greater than 3 months duration or minor amputation sites with less than 50% healing in 4 weeks.There were 13 (65%) males and the mean age was 65.7 (±11.6) years. The mean glycated haemoglobin (HbA1c) was 6.9 (±1.3) mmol mol−1 and mean wound duration before TOT was 114 (±79.1) days. 18/20 (90.0%) patients had concomitant lower limb revascularization angioplasty for chronic limb threatening ischaemia. The mean size of the foot ulcer at baseline was 11.3 ± 14.8 cm2 and mean transcutaneous oxygen measurement value was 34.1 (±19.6) mm Hg. Wound closure of >75% was observed in 14/20 (70.0%) patients. There was a 91.3% (±14.9%) wound area reduction by 3 months (P = .001) and mean time for 100% closure was 77.6 ± 32.5 days. Mean pain scores reduced from 2.4 (±1.8) at baseline to .5 (±1.0) at 3 months (P = .008). All patients were very satisfied using the ambulatory device. Use of TOT in chronic diabetic foot wounds stimulates a healing state, underpinning the concept that oxygen plays a central role in wound healing. Our results are more compelling if you consider they started with relatively large-sized DFUs and majority of patients were frail with underlying peripheral artery disease. (NCT03863054)

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“…Can Natrox™ be used synergistically with other wound therapies such as topical haemoglobin to increase oxygen delivery to the chronic DFU? 32 …”

Section: Discussionmentioning

confidence: 99%

An Observational Clinical Trial Examining the Effect of Topical Oxygen Therapy (Natrox^™) on the Rates of Healing of Chronic DiAbetic Foot Ulcers (OTONAL Trial)

Tang

Mak

Yap

et al. 2021

The International Journal of Lower Extremity Wounds

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“… 15 Low HGB indicates that the oxygen carrying function of the blood is reduced, which may lead to ischemia and hypoxia of the incision tissue, delaying wound healing. 16 and tissue hypoxia is a common issue in such wounds. Granulox (SastoMed GmbH, Georgsmarienhütte, Germany Therefore, nutritional support should be strengthened after operation to prevent hypoalbuminemia and malnutrition.…”

Section: Discussionmentioning

confidence: 99%

A prediction model of risk factors of poor wound healing after craniocerebral surgery

Zhong,

Lu,

Xie

et al. 2023

Pak J Med Sci

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Objective: To explore the independent risk factors of poor wound healing after craniocerebral surgery, and to generate a risk prediction model. Methods: A single-center retrospective observational analysis of 160 patients who underwent craniocerebral surgery in The 904th Hospital of the Joint Logistics Support Force of the PLA from February 2018 to February 2021 was carried out. Patients were divided into Group-A (n=70) and Group-B (n=90) according to postoperative wound healing outcome. Logistic regression was used to analyze the independent risk factors, and a nomogram prediction model was constructed using R software. The receiver operating characteristic (ROC) curve was used to test the predictive ability of the model, and the fitting effect was verified by Hosmer Lemeshow. Results: The duration of operation, surgical site infection, diabetes mellitus, and the time of intubation in Group-B were significantly lower than Group-A (P<0.05). Serum albumin (ALB) and hemoglobin (HGB) in Group-B were significantly higher than those in Group-A (P<0.05). Logistic regression analysis showed that long operation duration, surgical site infection, duration of drainage tube, ALB <35g/L, and abnormal HGB were independent risk factors for poor wound healing (P<0.05). The area under the ROC curve (AUC) predicted by the model was 0.932, 95%CI (0.862~1.000). The Hosmer-Lemeshow goodness of fit test showed that the expected probability calculated by the model matched the actual probability (P>0.05). Conclusions: Long operation duration, surgical site infection, duration of drainage tube, ALB <35g/L, and abnormal HGB were risk factors for poor wound healing. The nomograph model based on these factors showed good discrimination, calibration, and clinical effectiveness in predicting poor wound healing. doi: https://doi.org/10.12669/pjms.39.6.7963 How to cite this: Zhong C, Lu W, Xie W, Jiao W. A prediction model of risk factors of poor wound healing after craniocerebral surgery. Pak J Med Sci. 2023;39(6):---------. doi: https://doi.org/10.12669/pjms.39.6.7963 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…Several approaches using sprays have been used, from the administration of drugs [6][7][8] and topical therapy [9] to more advanced treatments, such as cell therapy [10]. Recently published review articles have highlighted specially the application of hemoglobin sprays [11,12], sprayable hydrogels [13,14], and mostly cell sprays [15,16]. However, discussions featuring spray-applied bioactive wound dressings have not yet been properly addressed.…”

Section: Introductionmentioning

confidence: 99%

Sprayable Bioactive Dressings for Skin Wounds: Recent Developments and Future Prospects

Nozaki

Lima

Moraes

2022

Biomedical Materials & Devices

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The skin, as the body's main protection barrier from the environment, has an intrinsic self-repairable nature. However, proper wound healing only occurs under appropriate conditions. Skin wounds represent an economic burden on healthcare systems worldwide. Recent research has focused on developing new therapies, especially for chronic wounds. Among them, sprayapplied therapies have emerged as a promising strategy for allowing deeper penetration of the products, better conformability, easiness of application, lower discomfort for the patient, and lower risk of contamination during application. Specifically, sprayable wound dressings have been getting attention for enabling the treatment of severe cases or hard-to-heal wounds by incorporating different bioactive agents. Organic and inorganic compounds, natural extracts, signaling compounds, and live human cells have been investigated. In this context, this review summarizes the main findings of recently developed spray-applied bioactive wound dressings.

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Granulox—The Use of Topical Hemoglobin to Aid Wound Healing: A Literature Review and Case Series From Singapore

Cited by 10 publications

References 21 publications

An Observational Clinical Trial Examining the Effect of Topical Oxygen Therapy (Natrox^™) on the Rates of Healing of Chronic DiAbetic Foot Ulcers (OTONAL Trial)

An Observational Clinical Trial Examining the Effect of Topical Oxygen Therapy (Natrox^™) on the Rates of Healing of Chronic DiAbetic Foot Ulcers (OTONAL Trial)

A prediction model of risk factors of poor wound healing after craniocerebral surgery

Sprayable Bioactive Dressings for Skin Wounds: Recent Developments and Future Prospects

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Granulox—The Use of Topical Hemoglobin to Aid Wound Healing: A Literature Review and Case Series From Singapore

Cited by 10 publications

References 21 publications

An Observational Clinical Trial Examining the Effect of Topical Oxygen Therapy (Natrox™) on the Rates of Healing of Chronic DiAbetic Foot Ulcers (OTONAL Trial)

An Observational Clinical Trial Examining the Effect of Topical Oxygen Therapy (Natrox™) on the Rates of Healing of Chronic DiAbetic Foot Ulcers (OTONAL Trial)

A prediction model of risk factors of poor wound healing after craniocerebral surgery

Sprayable Bioactive Dressings for Skin Wounds: Recent Developments and Future Prospects

Contact Info

Product

Resources

About

An Observational Clinical Trial Examining the Effect of Topical Oxygen Therapy (Natrox^™) on the Rates of Healing of Chronic DiAbetic Foot Ulcers (OTONAL Trial)

An Observational Clinical Trial Examining the Effect of Topical Oxygen Therapy (Natrox^™) on the Rates of Healing of Chronic DiAbetic Foot Ulcers (OTONAL Trial)