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Topical oxygen wound therapies for chronic wounds: a review

02 July 2019
Volume 3 · Issue 3

Abstract

Chronic wounds are an increasing problem in our ageing population and can arise in many different ways. Over the past decades it has become evident that sufficient oxygen supply is an essential factor of appropriate wound healing. Sustained oxygen deficit has a detrimental impact on wound healing, especially for patients with chronic wounds. This has been proven for wounds associated with peripheral arterial occlusive disease (PAOD) and diabetic foot ulcers (particularly in combination with PAOD). However, this is still under debate for other primary diseases.

In the past few years several different new therapeutic approaches for topical oxygen therapies have been developed to support wound healing. These tend to fall into one of four categories: (1) delivery of pure oxygen either under pressurised or (2) ambient condition, (3) chemical release of oxygen via an enzymatic reaction or (4) increase of oxygen by facilitated diffusion using oxygen binding and releasing molecules. In this review article, the available therapeutic topical oxygen-delivering approaches and their impact on wound healing are presented and critically discussed. A summary of clinical data, daily treatment recommendations and practicability is provided.

The most common chronic wounds are leg ulcers, foot ulcers and pressure ulcers (PU).1,2 In most cases, patients with such wounds suffer from peripheral arterial occlusive disease (PAOD), chronic venous insufficiency (CVI) and/or diabetes mellitus, or, in the case of PUs, immobility. It is generally accepted that, in PAOD and diabetic foot syndrome, a disturbance in the vascular system results in a sustained inadequate supply of oxygen and finally chronic hypoxia. These conditions dramatically increase the probability of developing a chronic wound.3,4 In patients with PAOD, the relationship between oxygen deficiency and reduced arterial perfusion has been well known for decades.5 Depending on the degree of the reduction, the hypoxia reaches a critical threshold below which wound healing is significantly decreased. This stage of PAOD is termed chronic critical ischaemia.6

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