Topical Oxygen Therapy Treatment of Extensive Leg and Foot Ulcers

DANIEL R. IGNACIO, MD, ALFRED P. PAVOT, MD, RIDA N. AZER, MD
LEONARD WISOTSKY, DPM

Journal of the American Podiabic Medical Association - Volume 75, Number 4, April 1985

Abstract
The authors present a study of 15 patients with extensive leg ulcers of at least a grade Ill out of five grades, who were treated with topical oxygen treatment. A 73.3% healing rate was obtained. Three patients required further amputation and one patient eventually died. Failures to heal were associated with severe ischemic diseases and tissue hypoxia. Management of severe wound infections of the limbs required multidisciplinary treatment, which included the use of high-pressure oxygen treatment.

A great landmark in medical history was the discovery of oxygen in 1775 by Priestly, who demonstrated that oxygen maintains the vitality of a candle light and suggested its usefulness to human life. This great event was followed by the introduction of a hyperbaric chamber by the British physician, Henshaw.' Henshaw's hyperbaric chamber may rank in importance with such medical achievements as the discovery of antibiotics, blood transfusion, and anesthesia. The progress of the hyperbaric chamber culminated in 1879 with Fontaine's use of a hyperbaric operating room. "With this chamber," Fontaine claimed, "one can do surgery in hospitals, sanitoriums, and private homes.Thanks to our colleagues in military medicine, the use of hyperbaric oxygen has finally gained its long over due recognition in clinical practice. A major development in the field of hyperbaric oxygen treatment is the delineation of its specific indication by the Hyperbaric Oxygen Committee of the Undersea Medical Society, which in the 1970s defined four categories of clinical I and I1 illustrate the value of oxygen in wound healing and the management of diffhlt, if not incurable, wounds. The use of the hyperbaric oxygen chamber varies in many forms, ranging from the traditional model of huge and complicated walkin chambers to the use of a small plastic or metal chamber. However, this method of providing oxygen to a local open wound is complicated, expensive. and fraught with potential dangers and probable life-threatening adverse effect.

Olejnicjak originally reported in the mid 1960s the application of high pressure oxygen delivered topically to injured extremities. More recently, the use of soft, vinyl, inflatable sleeves, which are disposable, for application of topical oxygen treatment have been tried. To gain wider acceptance of its clinical usage, high-pressure oxygen treatment should be provided in a simple, safe, and inexpensive system of delivery supported by clinical studies.

The purpose of this paper is to demonstrate that topical high-pressure oxygen treatment, when combined with multidisciplinary treatment approach, offers an effective management of severe limb wounds.