M.bennett at 01:17, 10 October 2021

2021-10-10T01:17:11Z

Gordoben: Imported from Wikispaces

2019-01-18T06:25:32Z

Imported from Wikispaces

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'''The addition of hyperbaric oxygen to a burn care protocol resulted in a reduction in the time required for burn to heal.'''

'''Clinical Bottom Line:'''
1. The addition of hyperbaric oxygen to a burn care protocol resulted in a reduction in the time required to heal burns.
2. Any effect of the addition of hyperbaric oxygen on fluid requirements and graft success remains unclear.

**Appraised by:''' Mike Bennett, Dept of Diving and Hyperbaric Medicine, Prince of Wales Hospital
Sydney; Thursday, 22 April 1999

**Clinical Scenario:''' A patient presented with thermal burns and we wondered if the addition of hyperbaric oxygen would improve healing time.
**Three-part Question:''' In patients with thermal burns, does the addition of hyperbaric oxygen to a standard burn care protocol result in any improvement in time required to heal, or the quality of healing?
**Search Terms:''' Thermal burns

**The Study:'''
Double-blinded concealed randomised controlled trial with intention-to-treat.
Patients with between 10 and 50% of body surface area thermal burns presenting to a burns centre within 24 hours of injury.
'''Control group''' (N = 16; 16 analysed): A standard burns protocol with fluid resuscitation, dressings and surgical procedures. Sham hyperbaric exposures in a chamber compressed to 1.3ATA and returned to 1ATA gradually at beginning and end of time period.
'''Experimental group''' (N = 16; 16 analysed): Protocol as above plus 100% oxygen breathing at 2ATA for 90 minutes every 8 hours in the first 24 hours, then 12 hourly until healed.

**The Evidence:'''
{|
| '''Non-event outcomes''' || '''Time to outcome''' || '''Air group''' || '''HBO group''' || '''P-value'''
|-
| '''Average volume of crystalloid required (mls/kg/%BSA)''' || 24 hours || 3.4 || 2.2 || Not tested
|-
| '''Mean healing time (days)''' || Healing || 43.8 || 19.7 || <0.005
|-
|}
**Comments:'''
1. Small study with paired stratification by surface area burnt.
2. Good randomisation and blinding.
3. Power to detect a significant improvement in fluid requirements or graft success unknown, but likely to be low.
4. Some suggestion of improvement in proportion of grafts taking in hyperbaric group (1/2 controls, 2/2 HBO).
4. Morbidity and mortality data in this paper do not relate to this RCT.

**Expiry date:''' December 2024
**References: '''
1. Hart GB, O'Reilly RR, Broussard ND, Goodman DB, Yanda RL. Treatment of burns with hyperbaric oxygen. Surgery, Gynaecology and Obstetrics 1974; 139:693-696.



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'''[[Burns | BACK]]'''

Hart - Revision history

M.bennett at 01:17, 10 October 2021

Gordoben: Imported from Wikispaces