Predictors for success of hyperbaric oxygen therapy for problematic wounds

Q1 Medicine Wound Medicine Pub Date : 2020-09-01 DOI:10.1016/j.wndm.2020.100187
Kamonwan Jenwitheesuk , Ajanee Mahakkanukrauh , Wiyada Punjaruk , Kriangsak Jenwitheesuk , Kengkart Winaikosol , Puttama Punyavong , Narongchai Wongkonkitsin , Supatcha Prasertcharoensuk , Phasuk Limrattanapimpa
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Abstract

Objective

Our aim was to determine the treatment outcome using HBOT for both acute and chronic problematic wounds.

Methods

This was a case-control study conducted at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand between 2012 and 2017. The inclusion criterion was all patients with either acute or chronic wounds with delayed wound healing treated with hyperbaric oxygen therapy (HBOT). Wound improvement was the primary outcome.

Results

Eighty-eight patients were included. Sixty-eight patients (77 %) had improved wound healing while 20 (23 %) had a poor treatment outcome. In the improved wound healing group, the outcome of wound healing was classified into 2 groups: Group 1–40 patients (58.8 %) experienced wound healing while Group 2–28 patients (41.2 %) experienced decreased wound size and reduced pain. The factors prognostic for a poor treatment outcome were arterial occlusion (OR 19.667, 95 % CI 5.740–67.378), diabetes (OR 3.405, 95 % CI 1.198–9.679), and bone exposure (OR 10.389, 95 % CI 2.763–39.058).

Conclusion

Among patients with problematic wounds undergoing HBOT, the factors associated with a poor prognosis were arterial occlusion, DM, and wound with bone exposure.

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问题伤口高压氧治疗成功的预测因素
目的我们的目的是确定使用HBOT治疗急性和慢性问题伤口的结果。方法采用2012 - 2017年在泰国孔敬恩大学医学院斯利那加林医院开展的病例对照研究。纳入标准是所有接受高压氧治疗(HBOT)的急性或慢性伤口延迟愈合的患者。伤口改善是主要结局。结果共纳入88例患者。68例(77%)患者伤口愈合改善,20例(23%)治疗效果较差。创面愈合改善组创面愈合情况分为2组:1 ~ 40组创面愈合(58.8%),2 ~ 28组创面缩小、疼痛减轻(41.2%)。预后不良的因素为动脉闭塞(OR 19.667, 95% CI 5.740-67.378)、糖尿病(OR 3.405, 95% CI 1.198-9.679)和骨暴露(OR 10.389, 95% CI 2.763-39.058)。结论在问题创面行HBOT的患者中,与预后不良相关的因素有动脉闭塞、糖尿病和创面骨外露。
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Wound Medicine
Wound Medicine Medicine-Surgery
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