The role of oxygen‐associated therapies for the healing of chronic wounds, particularly in patients with diabetes

Abstract

This paper discusses the role of molecular oxygen as an aid to wound healing, and the potential value of the three major therapies which allow the delivery of oxygen to the wound site: Hyperbaric Oxygen Therapy (HBOT), Topical Oxygen Therapy (TOT) and a new sterile wound dressing, Oxyzyme™. We summarize studies which have been undertaken using these interventions, and discuss their reported effect on chronic, non-healing wounds, in particular, on ulcers associated with Diabetes. The main conclusions drawn from the studies reviewed indicate that therapeutic oxygen can be used as an aid to the healing of chronic wounds; and benefits are clearly evident with the use of both HBOT and TOT. There is also potential for the use of a new, portable, topical oxygen delivery system, oxyzyme. However its use is still embryonic and studies on its effectiveness are limited. More robust measures of its efficacy are urgently needed.

A randomised trial to compare the performance of Oxyzyme® and Iodozyme® with standard care in the treatment of patients with venous and mixed venous/arterial ulceration

“…However, a recent review of the literature on Oxyzyme highlighted the evidence from a number of case series in the literature [12]. The…”

Systemic administration of hemoglobin improves ischemic wound healing

“…Currently, two major methods of oxygen therapy have been used to improve the tissue oxygen tension in ischemic wounds [13]. Systemic hyperbaric oxygen therapy (HBOT) has been used clinically in the treatment of diabetic ulcers and chronic lower limb ischemia for over five decades and involves the inhalation of pure oxygen under oxygen pressure of 2 atmosphere or higher in a sealed chamber [14,15].…”

Biochemical and Biophysical Cues in Matrix Design for Chronic and Diabetic Wound Treatment

“…82 Historically, hyperbaric oxygen therapies (HBOTs) were developed in which the body is intermittently exposed to pure oxygen in a stationary pressure chamber. 83 HBOT delivers the oxygen through a systematic circulation; therefore, its efficacy is limited in tissues with poor circulation. Since the late 1960s, a topical oxygen therapy has been developed, which involves applying pure oxygen with sealing around wound tissues for about 90 min, once a day at a pressure slightly above ambient atmospheric pressure.…”

“…84 More recently, oxygen-releasing wound dressings (e.g., OxyzymeÔ) have been commercialized to promote wound healing by eliminating cellular hypoxia after tissue damage. 83 Instead of attaching a bag filled with pure oxygen, the Oxyzyme system generates oxygen by chemical reaction.…”