Difference between revisions of "Niezgoda"

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'''<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">Hyperbaric oxygen may be associated with some reduction in wound size, exudate and hyperaemia following a standard injury model.</span>'''
 
  
<span style="border-color: windowtext; border-style: solid; border-width: 1.5pt; display: block; padding: 1pt 4pt;"><span style="padding-bottom: 0cm; padding-left: 0cm; padding-right: 0cm; padding-top: 0cm;">'''<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">Clinical Bottom Line:</span>'''</span>
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<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="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">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 2 only. </span>
 
</span>
 
**<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">Appraised by:</span>'''<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;"> Mike Bennett, Dept of Diving and Hyperbaric Medicine, Prince of Wales Hospital</span>
 
<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">Sydney; Thursday, 25 March 1999</span>
 
  
**<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">Clinical Scenario:</span>'''<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;"> A patient with thermal burns presented for treatment, we wondered if adding hyperbaric oxygen to the treatment would improve outcome. </span>
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<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="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">Three-part Question:</span>'''<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;"> 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 style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">Search Terms:</span>'''<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;"> burns</span>
 
  
**<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">The Study:</span>'''
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<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="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">Double-blinded concealed randomised controlled trial with intention-to-treat.</span>
 
<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">Healthy, non-smoking volunteers with a standard wound inflicted on the forearm.</span>
 
<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">'''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.</span>
 
<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">'''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.</span>
 
  
**<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">The Evidence:</span>'''
+
----
{|
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| <span style'''"line-height: normal; margin-bottom: 0pt;">'''Non-event outcomes'''</span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style'''"display: block; text-align: center;">'''Time to outcome'''</span></span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style'''"display: block; text-align: center;">'''Control group'''</span></span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style'''"display: block; text-align: center;">'''HBO group'''</span></span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style="display: block; text-align: center;">'''P-value'''</span></span>  
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<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'''"line-height: normal; margin-bottom: 0pt;">'''Hyperaemia(perfusion units)'''</span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style'''"display: block; text-align: center;">Day 2</span></span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style'''"display: block; text-align: center;">25.0</span></span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style'''"display: block; text-align: center;">14.4</span></span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style="display: block; text-align: center;">0.05</span></span>  
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| 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'''"line-height: normal; margin-bottom: 0pt;">'''exudate/day (g)'''</span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style'''"display: block; text-align: center;">Day 2</span></span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style'''"display: block; text-align: center;">0.30</span></span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style'''"display: block; text-align: center;">0.19</span></span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style="display: block; text-align: center;">0.03</span></span>  
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| 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'''"line-height: normal; margin-bottom: 0pt;">'''Wound size (cm2)'''</span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style'''"display: block; text-align: center;">Day 2</span></span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style'''"display: block; text-align: center;">0.95</span></span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style'''"display: block; text-align: center;">0.61</span></span> || <span style'''"display: block; line-height: normal; margin-bottom: 0pt; text-align: center;"><span style="display: block; text-align: center;">0.04</span></span>  
+
| 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: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">'''Comments:'''</span>
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<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: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">1. Statistically significant differences on day two only.</span>
+
 
<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">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>
+
'''Comments:'''
<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">3. Clinical relevance unclear.</span>
+
 
 +
<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>
 +
 
 +
&nbsp;
 +
 
 +
<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="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">Expiry date:</span>'''<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;"> December 2024</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: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">References: </span>'''
 
<span style="font-family: &#39;Times New Roman&#39;,&#39;serif&#39;; font-size: 16px;">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 style="display: block; text-align: center;">
 
  
</span>
+
[[File:Sumhorsa.gif|center|Sumhorsa.gif]]
[[File:sumhorsa.gif|center]]
 
  
<span style="color: #7c00ff; display: block; font-size: 26px; text-align: center;">'''[[Burns | BACK]]'''</span>
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<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

Sumhorsa.gif

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