Hyperbaric oxygen therapy enables pain reduction and healing in painful chronic wounds, including in calciphylaxis.

Abstract

Background: The effects of hyperbaric oxygen therapy (HBOT) on wound healing have been demonstrated mainly in diabetic foot ulcer.

Objectives: To study the efficacy and safety of HBOT in chronic painful wounds, excluding diabetic foot ulcers.

Methods: From 2008 to 2021, patients with chronic wounds showing no clinical improvement for more than 1 month, who were in pain despite the use of level 2 or 3 analgesics, and who had undergone HBOT sessions, were included in a monocentric retrospective study. The primary objective was to evaluate the course of pain by studying analgesic consumption before and up to a maximum of 12 months after HBOT. Achievement of complete or partial healing was also recorded.

Results: Eighteen patients with calciphylaxis (n = 6), vasculitis (n = 4), hypertensive leg ulcer (n = 3), mixed ulcer (n = 3), Buerger's disease (n = 1), and livedoid vasculitis (n = 1) were included. Decrease in analgesic step, dose or number was noted in 15 of 18 patients (83.3%) within a median time of 3.5 (0.3-12) months, with a significant decrease in strong opioid use (72.2% before vs. 11.1% after, p = 0.005), as well as local improvement in 15 of 18 patients (83.3%) within a median time of 3.9 (1-10.3) months.

Conclusion: HBOT as an adjuvant in chronic painful wounds of various etiologies allows a significant reduction in strong opioid consumption. This finding in a population with frequent adverse reactions to opioids requires demonstration in prospective and controlled studies.