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Curr Pharm Des. 2019 Jul 3. doi: 10.2174/1381612825666190703162648. [Epub ahead of print]

Therapeutic Effects of Hyperbaric Oxygen in the Process of Wound Healing.

Author information

1
Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands & CIBEROBN (Physiopathology of Obesity and Nutrition), E-07122, Palma de Mallorca, Balearic Islands. Spain.
2
MEDISUB Recerca (Institut de Recerca Hiperbàrica), Camí d'Aucanada 52, E-07410 Pto. de Alcúdia, Balearic Islands. Spain.
3
Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, 14359-16471 Tehran. Iran.

Abstract

Chronic and non-healing wounds, especially diabetic foot ulcers and radiation injuries, imply a remarkable morbidity with a significant effect on the quality of life and a high sanitary cost. The management of these wounds requires complex actions such as surgical debris, antibiotic treatment, dressings and even revascularization. These wounds are characterized by poor oxygen supply resulting in inadequate oxygenation of the affected tissue. The adjuvant treatment with hyperbaric oxygen therapy (HBOT) may increase tissue oxygenation favoring the healing of wounds which do not respond to the usual clinical care. The increase in partial pressure of oxygen contributes to cover the energy demands necessary for the healing process and reduces the incidence of infections. Moreover, the increase in oxygen leads to the production of reactive species with hormetic activity, acting on signaling pathways that modulate the synthesis of inflammation mediators, antioxidants and growth factors which can contribute to the healing process. Studies performed with cell cultures and in animal models seem to demonstrate the beneficial effects of HBOT. However, clinical trials do not show such conclusive results; thus, additional randomized placebo-controlled studies are necessary to determine the real efficacy of HBOT and the mechanism of action for various types of wounds.

KEYWORDS:

chronic wounds; diabetic ulcer; hyperbaric oxygen; reactive species; wound healing

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