Niezgoda
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