Hart
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.
