Physiologic Effects Of Hyperbaric Oxygen On Wound Healing Processes

Juha Niinikoski

Department of Surgery, University of Turku, FI-20520 Turku, Finland

Abstract: The value of hyperbaric oxygenation has been well established in the treatment of hypoxic and ischemic wounds in which local oxygen tensions are below optimal for healing. The greatest benefit of hyperbaric oxygen therapy is achieved in situations where the nutritive flow and oxygen supply to the repair tissue are compromised by local injury or infection, but in which the regional vascular network, a prerequisite for oxygen to reach tissues is intact or only partly damaged. On the other hand, hyperbaric oxygen seems to possess significant angiogenic potential in tissues suffering from chronic lack of oxygen due to defective vasculature. During wound healing the presence of oxygen takes on additional importance because of the increased demand of reparative processes like cell proliferation and synthesis of collagen. In addition, superoxide generation by polymorphonuclear leukocytes, which is essential for bacterial killing, is critically dependent on tissue oxygen levels. Ischemic soft tissues also benefit from hyperoxygenation through improved preservation of energy metabolism and reduction of edema. It may be generally stated, that any treatment that augments the oxygen supply or avoids hypoperfusion of the wound tissue tends to increase the rate of healing and decrease the susceptibility to infection

Keywords: hyperbaric oxygen therapy; wound healing; tissue repair; wound contraction;

wound epithelization; wound environment; tissue perfusion; growth factors; cytokines; lactate; wound energy metabolism; angiogenesis; cell proliferation; cell differentiation; nucleic acids; fibroblast; collagen synthesis; bacterial killing; oxidative burst; wound infection; wound ischemia; wound edema; tissue hypoxia; problem wounds; tissue oxygen tension; transcutaneous oxygen tension; oxygen tension measurements; rabbit ear chamber

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