Systematic review of the effects of topical oxygen therapy on wound healing

Background

Various adjunct therapies are available for wound healing in addition to standard care. Topical oxygen therapy (TCOT) is one such novel therapy. We conducted a systematic review and meta-analysis to evaluate the role of TCOT in the healing of cutaneous wounds of any etiology.

Methods

The review was conducted on articles related to wounds treated with TCOT identified through PubMed, MEDLINE/OVID, Cochrane, and Google Scholar. We included randomized controlled trials, double-arm prospective studies, single-arm prospective studies, case-control series, and case reports published on or after 2012. Only articles addressing TCOT were included; other forms of oxygen delivery were excluded. We aimed to evaluate the proportion of wounds completely healed, the percent decrease in wound area of those not completely healed, the recurrence of wounds after treatment, and effects on pain and ulcer rating scales.

Results

A total of 22 articles were included in this review. The results showed that TCOT has a significant salutary effect on complete wound healing in case-control studies (odds ratio, 4.48; 95% confidence interval, 2.05-9.77; P < .001; I² = 76.34%) and in single-arm studies (pooled prevalence, 0.48 [48.0%]; 95% confidence interval, 0.34-0.62; P < .001; I² = 86.58). However, no significant effect was observed for percent wound reduction, the difference in ulcer grade scores, or the difference in pain scores. Most of the included studies had a high risk of bias because they were not blinded, were single-arm studies, or were case reports.

Conclusions

Our findings indicate that TCOT can have a positive effect on wound healing when compared with standard care. However, owing to the lack of randomized, controlled trials or studies with comparable end points, a definitive conclusion on the full impact of TCOT on wound healing cannot be reached. More high-quality data are needed to definitively determine the effects of TCOT on wound healing, preferably from a comprehensive, randomized controlled trial.