Guidelines for the use of topical oxygen therapy in the treatment of hard-to-heal wounds based on a delphi consensus
Agrowing body of evidence supports the use of topical oxygen therapy (TOT) in the treatment of diabetic foot ulcers (DFUs). Anecdotal evidence suggests that topical oxygen may be effective in the treatment of other wound types. In May 2021, leaders in the field of wound healing from across the US assembled in New Orleans. In one of the interactive sessions, several physicians reviewed and discussed the evidence for TOT, and attendees shared their experiences in treating patients with TOT. The conference highlighted the need for a consensus document for the use of topical oxygen in patients with hard-to-heal wounds. Subsequently, a Delphi method was employed to establish consensus guidelines for prescribing TOT. A multidisciplinary panel of 23 wound experts (15 wound specialists, six vascular surgeons, one plastic surgeon, one critical care provider and one PhD researcher) participated in two rounds of questionnaires. The Delphi survey questions focused on the indications for topical oxygen, when to prescribe the therapy, pretreatment work-up, visit frequency and length of therapy. A clinical workflow algorithm was also included as part of the Delphi. After two rounds, the Delphi participants were able to reach a consensus of >77% on when to prescribe topical oxygen, the wound types that may benefit from the therapy, pretreatment wound preparation, work-up and length of therapy. The goal of the guidelines is to standardise the use of topical oxygen and inform further research efforts.
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