Angiogenesis in Necrotic Ulcers Treated With Hyperbaric Oxygen

Madalene C.Y. Heng, MD, FRACP, FACD; Judith Harker, PhD; George Crathy, MD; Charles Marshall, MD; Joselynn Brazier, MD; Socorro Sumampong, RN; Edna Paterno Gomez, RN

Ostomy Wound Management - Volume 46, Issue 9, September 2000

Abstract
Necrotic/gangrenous wounds lack adequate blood supply and develop further vascular damage from either reperfusion injury or oxygen toxcicity when exposed to oxygen as the wrong pressure. A perspective randomized study was performed to confirm the efficacy of topical hyperbaric oxygen at 1.004 to 1.013 atmospheres (THOT) in stimulating angiogenesis and healing of necrotic/gangrenous wounds. Participants included 40 inpatients (79 ulcers) recruited over 12 months who wwere assigned to treatments by either THOT or standard wound care (SWC). The results showed that 90% of the wounds healed in the THOT group compared to 22% in the SWC control. Repeated measures ANOVA on leg (ulcer size at 4 weeks) showed a significant group by time interaction, F(1.55) = 68.2 P< 0.0001. The size of ulcers (at 4 weeks) was significantly smaller with THOT, but larger with SWC. Capillary density?hpf (high power field) was significantly higher in THOT wounds than in SWC wounds (P< 0.001). It was concluded that THOT is effective in stimulating angiogenesis with enhanced healing of necrotic wounds.