Improvement of ischemic non-healing wounds following hyperoxygenation: the experience at Rambam-Elisha Hyperbaric Center in Israel, 1998-2007.

Background: Wounds of the lower extremities are a significant public health problem, being severe and costly to treat. Adjunctive treatment with hyperbaric oxygenation (HbOt) has proven to be a useful and cost-effective means of treating ischemic wounds, mainly in diabetic patients. Objectives: to describe patients with ischemic wounds treated at the rambam and elisha Hyperbaric Medical Center and their wound improvement following HbOt. Methods: We conducted a retrospective cohort study of all patients (N=385) treated in the center during 1998–2007 for ischemic non-healing wounds in the lower extremities. results: the mean age of the patients was 61.9 years (sD 13.97). Most of them were diabetic (69.6%) and male (68.8%). Half of the subjects had a wound for more than 3 months prior to undergoing pre-HbOt transcutaneous oximetry (tcpO2) testing. Most of the wounds were classified as Wagner degree 1 or 2 (39.1% and 46.2% respectively). the median number of treatments per patient was 29. Only 63.1% of patients had continuous treatments. Approximately 20% of patients experienced mild side effects. An improvement occurred in 282 patients (77.7%) following HbOt: 15.2% fully recovered, 42.7% showed a significant improvement (and were expected to heal spontaneously), and 19.8% a slight improvement. conclusions: HbOt can benefit the treatment of non-healing ischemic wounds (especially when aided by pretreatment tcpO2 evaluation; data not shown). Our experience shows that this procedure is safe and contributes to wound healing.