Angiogenesis in necrotic ulcers treated with hyperbaric oxygen.
Ostomy/wound management
confidence
Key findings
THOT healed 90% of necrotic wounds vs 22% SWC, with smaller ulcers and significantly higher capillary density indicating enhanced angiogenesis.
View source on PubMed (PMID 11189538) ↗
- Sample size
- 40 inpatients (79 ulcers)
- Population
- Inpatients with necrotic/gangrenous wounds
- Dosing
- Topical hyperbaric oxygen at 1.004 to 1.013 atmospheres
- Duration
- 4 weeks (recruited over 12 months)
- Route
- Topical hyperbaric oxygen (THOT)
- Blinding
- not_reported
- Controls
- active_comparator
- Drug class
- physical modality
Measured endpoints
- wound healing rateImprovedwound_healingsignificanteffect: 90% healed (THOT) vs 22% (SWC)
- ulcer size at 4 weeksDecreasedwound_healingsignificanteffect: F(1,55) = 68.2
- capillary density (angiogenesis)Increasedcardiovascularsignificant
Full abstract
Necrotic/gangrenous wounds lack adequate blood supply and develop further vascular damage from either reperfusion injury or oxygen toxicity when exposed to oxygen at the wrong pressures. A prospective randomized study was performed to confirm the efficacy of topical hyperbaric oxygen at 1.004 to 1.013 atmospheres (THOT) in stimulating angiogenesis and healing of necrotic/gangrenous wounds. Participants included 40 inpatients (79 ulcers) recruited over 12 months who were assigned to treatment by either THOT or standard wound care (SWC). The results showed that 90% of the wounds healed in the THOT group compared to 22% in the SWC controls. Repeated measures ANOVA on log (ulcer size at 4 weeks) showed a significant group by time interaction, F(1,55) = 68.2, P < 0.0001. The size of ulcers (at 4 weeks) was significantly smaller with THOT, but larger with SWC. Capillary density/hpf (high power field) was significantly higher in THOT wounds than in SWC wounds (P < 0.001). It was concluded that THOT is effective in stimulating angiogenesis with enhanced healing of necrotic wounds.