Difference between revisions of "Niezgoda"
(Imported from Wikispaces) |
|||
Line 1: | Line 1: | ||
− | |||
− | <span style=" | + | <span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:" times="" new="" roman",serif"="">Hyperbaric oxygen may be associated with some reduction in wound size, exudate and hyperaemia following a standard injury model.</span></span>'''</span> |
− | |||
− | |||
− | |||
− | |||
− | + | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"="">Clinical Bottom Line:</span></span>'''</span> | |
− | |||
− | |||
− | + | <span style="line-height:normal"><span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"="">1. The addition of hyperbaric oxygen treatment in this model of a burn injury was associated with a reduction of wound size, exudate and hyperaemia on day two only.</span></span></span> | |
− | <span style=" | ||
− | <span style="font-family: | ||
− | |||
− | <span | ||
− | + | ---- | |
− | + | ||
− | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Citation(s):</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">1. Niezgoda JA, Cianci P, Folden BW, Ortega RL, Slade JB, Storrow AB. The effect of hyperbaric oxygen therapy on a burn wound model in human volunteers. Plastic and Reconstructive Surgery 1997; 99:1620-1625.</span></span></span> | |
+ | |||
+ | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Clinical Scenario:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">A patient with thermal burns presented for treatment, we wondered if adding hyperbaric oxygen to the treatment would improve outcome.</span></span></span> | ||
+ | |||
+ | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Three-part Question:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">For patients with thermal burns, does the addition of hyperbaric oxygen to the standard treatment result in any improvement in the rate of healing?</span></span></span> | ||
+ | |||
+ | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Search Terms:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">burns</span></span></span> | ||
+ | |||
+ | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">The Study:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Double-blinded concealed randomised controlled trial with intention-to-treat. Healthy, non-smoking volunteers with a standard wound inflicted on the forearm.</span></span></span> | ||
+ | |||
+ | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Control group</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">(N =6;6 analysed): Blister formed by suction, de-roofed and irradiated with UV light in a standard way. Wound then covered with hydrocolloid dressing renewed daily. Sham hyperbaric treatment started within 2 hours, twice daily for three days, at 2.4ATA on 8.75% oxygen for three thirty-minute periods separated by 10 minute air breaks. 100% oxygen decompression.</span></span></span> | ||
+ | |||
+ | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Experimental group</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">(N =6;6 analysed): As above, but hyperbaric sessions involved breathing of 100% oxygen for three thirty minute periods separated by 10 minute air breaks.</span></span></span> | ||
+ | |||
+ | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">The Evidence:</span></span>'''</span> | ||
+ | |||
+ | {| class="Table" style="border:solid windowtext 1.0pt" | ||
|- | |- | ||
− | | <span style | + | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Non-event outcomes</span></span>'''</span></p> |
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Time to outcome</span></span>'''</span></p> | ||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Control group</span></span>'''</span></p> | ||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">HBO group</span></span>'''</span></p> | ||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">P-value</span></span>'''</span></p> | ||
|- | |- | ||
− | | <span style | + | | style="border:solid windowtext 1.0pt" | |
+ | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Hyperaemia(perfusion units)</span></span>'''</span> | ||
+ | |||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Day 2</span></span></span></p> | ||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">25.0</span></span></span></p> | ||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">14.4</span></span></span></p> | ||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.05</span></span></span></p> | ||
|- | |- | ||
− | | <span style | + | | style="border:solid windowtext 1.0pt" | |
+ | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">exudate/day (g)</span></span>'''</span> | ||
+ | |||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Day 2</span></span></span></p> | ||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.30</span></span></span></p> | ||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.19</span></span></span></p> | ||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.03</span></span></span></p> | ||
|- | |- | ||
+ | | style="border:solid windowtext 1.0pt" | | ||
+ | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Wound size (cm2)</span></span>'''</span> | ||
+ | |||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Day 2</span></span></span></p> | ||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.95</span></span></span></p> | ||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.61</span></span></span></p> | ||
+ | | style="border:solid windowtext 1.0pt" | <p align="center" style="margin-bottom:0cm; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.04</span></span></span></p> | ||
|} | |} | ||
− | <span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:white">Comments:</span></span></span>'''</span> |
− | <span style="font-family: | + | |
− | <span style="font-family: | + | '''Comments:''' |
− | <span style="font-family: | + | |
+ | <span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">1. Statistically significant differences on day two only.</span></span></span> | ||
+ | |||
+ | <span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">2. Possibly inappropriate use of statistical analysis by use of multiple one-tail t-tests at times that may not have been a priori.</span></span></span> | ||
+ | |||
+ | <span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">3. Clinical relevance unclear.</span></span></span> | ||
+ | |||
+ | | ||
+ | |||
+ | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Appraised by:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Mike Bennett, Dept of Diving and Hyperbaric Medicine, Prince of Wales Hospital'''Sydney; Thursday, 25 March 1999</span></span></span> | ||
− | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Expiry date:</span></span>'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">December 2024</span></span></span> | |
− | |||
− | <span style="font-family: | ||
− | <span | ||
− | + | [[File:Sumhorsa.gif|center|Sumhorsa.gif]] | |
− | [[File: | ||
− | <span style="color: #7c00ff; display: block; font-size: 26px; text-align: center;">'''[[Burns | BACK]]'''</span> | + | <span style="color: #7c00ff; display: block; font-size: 26px; text-align: center;">'''[[Burns|BACK]]'''</span> |
Latest revision as of 21:38, 9 October 2021
Hyperbaric oxygen may be associated with some reduction in wound size, exudate and hyperaemia following a standard injury model.
Clinical Bottom Line:
1. The addition of hyperbaric oxygen treatment in this model of a burn injury was associated with a reduction of wound size, exudate and hyperaemia on day two only.
Citation(s):1. Niezgoda JA, Cianci P, Folden BW, Ortega RL, Slade JB, Storrow AB. The effect of hyperbaric oxygen therapy on a burn wound model in human volunteers. Plastic and Reconstructive Surgery 1997; 99:1620-1625.
Clinical Scenario:A patient with thermal burns presented for treatment, we wondered if adding hyperbaric oxygen to the treatment would improve outcome.
Three-part Question:For patients with thermal burns, does the addition of hyperbaric oxygen to the standard treatment result in any improvement in the rate of healing?
Search Terms:burns
The Study:Double-blinded concealed randomised controlled trial with intention-to-treat. Healthy, non-smoking volunteers with a standard wound inflicted on the forearm.
Control group(N =6;6 analysed): Blister formed by suction, de-roofed and irradiated with UV light in a standard way. Wound then covered with hydrocolloid dressing renewed daily. Sham hyperbaric treatment started within 2 hours, twice daily for three days, at 2.4ATA on 8.75% oxygen for three thirty-minute periods separated by 10 minute air breaks. 100% oxygen decompression.
Experimental group(N =6;6 analysed): As above, but hyperbaric sessions involved breathing of 100% oxygen for three thirty minute periods separated by 10 minute air breaks.
The Evidence:
Non-event outcomes |
Time to outcome |
Control group |
HBO group |
P-value |
Hyperaemia(perfusion units) |
Day 2 |
25.0 |
14.4 |
0.05 |
exudate/day (g) |
Day 2 |
0.30 |
0.19 |
0.03 |
Wound size (cm2) |
Day 2 |
0.95 |
0.61 |
0.04 |
Comments:
Comments:
1. Statistically significant differences on day two only.
2. Possibly inappropriate use of statistical analysis by use of multiple one-tail t-tests at times that may not have been a priori.
3. Clinical relevance unclear.
Appraised by:Mike Bennett, Dept of Diving and Hyperbaric Medicine, Prince of Wales HospitalSydney; Thursday, 25 March 1999
Expiry date:December 2024