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

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.