Therapeutic Outcome of Burn Patients Treated With Hyperbaric Oxygen

Abstract

Amongst various interventions for burns and inhalation injuries, hyperbaric oxygen therapy (HBOT) has recently been widely integrated as an adjunctive management of care due to its therapeutic properties in reducing tissue hypoxia, pathological inflammation, and augmenting neovascularization. However, the limitation of human clinical trials and data undermines its efficacy to be implemented as an adjunctive therapeutic modality in burns. The purpose of the literature review is to determine the efficacy of HBOT as an adjunct to standard management in burns. A review of the literature was done by searching PubMed, Cochrane, Medline, EMBASE, and Google Scholar for papers addressing the comparison of therapeutic outcomes between HBOT and non-HBOT in burns. Current research findings are conflicting, and the use of HBOT as an adjunct in burns management is still controversial. Therefore there is still a need for more data and research on the therapeutic benefits of HBOT in burn management.

Oxigenación hiperbárica como proceso complementario en la regeneración de la piel en quemadura térmica utilizando hiperoxia con vasoconstricción.

“…La cicatrización de la quemadura tiene tres fases: inflamación, reepitelización y resolución (Stevens & Page-Mc-Caw, 2012). Al aumentar la presión parcial de oxígeno en los tejidos, facilita su transporte por todo el organismo (Wasiak et al, 2006), estimula la síntesis de colágeno (Alyafi et al, 2021), la producción de fibroblastos (Doria et al, 2018) y la neoformación vascular (Duque Ramírez & Diab Forero, 2020), consiguiendo una rápida cicatrización, en la lesión que existe hipoxia e isquemia debido a la tensión del oxígeno (Marín et al, 2020). Las plaquetas son las primeras en llegar a la parte afectada, y posteriormente aparecen los macrófagos y los fibroblastos (Oley et al, 2021).…”

“…La OHB es una de las defensas más importantes frente al estrés oxidativo y radicales libres (Yildirim et al, 2000), en la epidermis es clave en la producción de fibroblastos (células que construyen la piel), es antiinflamatoria (Wu et al, 2021), neutraliza los radicales libres, que provocan las arrugas y el envejecimiento, ayuda a usar el Zinc, Cobre y Magnesio, la Mn-SOD (Manganeso Superoxidismutasa), protege a la mitocondria del daño de los radicales libres, estimula el centro de la memoria, es bacteriostático y también es bactericida (Alyafi et al, 2021;Oley et al, 2022).…”

Visualization and Bibliometric Analysis of Research Trends on Hyperbaric Oxygen Therapy

“…The Undersea and Hyperbaric Medical Society (UHMS) lists the indications of HBOT that are reimbursed in hospitals and clinics [12]. The Therapeutic Committee has approved (reimbursed) the following indications: decompression sickness; bubbles of air in blood vessels (air or gas embolism); carbon monoxide poisoning; idiopathic sudden sensorineural hearing loss [13]; myonecrosis; central retinal artery occlusion [14]; ischemia; cyanide poisoning; compartment syndrome; clostridial myositis; diabetically derived illness (such as difficulties in foot wound healing, retinopathy and nephropathy); delayed radiation injury; necrotizing soft osteomyelitis (refractory) [15]; crush injury and other acute trauma; exceptional blood loss (anaemia); enhancement of healing in selected problem wounds; intracranial abscess; mucormycosis; thermal burns (skin grafts and flaps) [16]; and tissue infections (necrotizing fasciitis) [17].…”

Influence of Hyperbaric Oxygenation and Antioxidant Therapy on Oxidative Metabolism in Patients With Burns

“…Tissue damage during thermal trauma leads to an increase in the formation of free radicals, hypoxia and depletion of antioxidant protection, the development of a systemic inflammatory response, endothelial dysfunction, microcirculation disorders and multiple organ failure [1]. An important factor in high mortality in burns is the development of oxidative stress (OS), which occurs as a result of an imbalance between the formation and neutralization of free radicals.…”