World Journal of Surgery

, Volume 28, Issue 3, pp 307–311 | Cite as

Clinical Hyperbaric Oxygen Therapy, Wound Perfusion, and Transcutaneous Oximetry

  • Juha H.A. NiinikoskiEmail author
World Progress in Surgery


Hyperbaric oxygen therapy (HBOT) is an important adjunct in the management of problem wounds which exist in chronic oxygen deficiency and in which the local oxygen tension is below optimal for healing. In the treatment of hypoxic and ischemic wounds, the most important effects of hyperbaric oxygenation are the stimulation of fibroblast proliferation and differentiation, increased collagen formation and cross-linking, augmented neovascularization, and the stimulation of leukocyte microbial killing. Ischemic soft tissues also benefit from hyperoxygenation through improved preservation of energy metabolism and reduction of edema. Hyperbaric oxygen is administered in either a multiplace or a monoplace hyperbaric chamber. Normally, pressures of 2 to 2.5 ATA are used for a period of 90 minutes once or twice daily. For an objective assessment of wound perfusion and oxygenation, transcutaneous oximetry provides a simple, reliable, noninvasive, diagnostic technique. It can be used for assessment of tissue perfusion in the vicinity of the problem wound. Transcutaneous oximetry may be used in the assessment of wound healing potential, selection of amputation level, and patient selection for HBOT. In diabetic patients with chronic foot ulcers peri-wound transcutaneous oxygen tensions (TcPo 2) over 400 mmHg in 2.5 ATA hyperbaric oxygen or over 50 mmHg in normobaric pure oxygen predict healing success with adjuncted HBOT with high accuracy.


Hyperbaric Oxygen Pyoderma Gangrenosum Hyperbaric Oxygen Therapy Problem Wound Hyperbaric Oxygen Treatment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Davis, JC, Buckley, CJ, Barr, PO 1988Compromised soft tissue wounds: correction of wound hypoxiaDavis, JCHunt, TK eds. Problem Wounds. The Role of OxygenElsevierNew York143152Google Scholar
  2. 2.
    Marx, RE 1994Radiation injury to tissueKindwall, EP eds. Hyperbaric Medicine PracticeBest Publishing CompanyFlagstaff AZ447503Google Scholar
  3. 3.
    Niinikoski, J, Hunt, TK 1996Oxygen and healing wounds: tissue-bone repair enhancementOriani, GMarroni, AWattel, F eds. Handbook of Hyperbaric MedicineSpringer-VerlagMilan485507Google Scholar
  4. 4.
    Knighton, DR, Halliday, B, Hunt, TK 1984Oxygen as an antibiotic: the effect of inspired oxygen on infectionArch. Surg.119199204PubMedGoogle Scholar
  5. 5.
    Nylander, G, Nordström, H, Eriksson, E 1984Effects of hyperbaric oxygen on edema formation after a scald burnBurns10193196Google Scholar
  6. 6.
    Boerema, I, Meyne, NG, Brummelkamp, WK,  et al. 1960Life without blood. A study of the influence of high atmospheric pressure and hypothermia on dilution of the bloodJ. Cardiovasc. Surg.1133146Google Scholar
  7. 7.
    Strauss, MB, Hart, GB 1984Crush injury and the role of hyperbaric oxygenTopics Emerg. Med.6924Google Scholar
  8. 8.
    Nylander, G, Lewis, D, Nordström, H,  et al. 1985Reduction of postischemic edema with hyperbaric oxygenPlast. Reconstr. Surg.76596601PubMedGoogle Scholar
  9. 9.
    Matos, LA, Nuñez, AA 1994Enhancement of healing in selected problem woundsKindwall, EP eds. Hyperbaric Medicine PracticeBest Publishing CompanyFlagstaff AZ589612Google Scholar
  10. 10.
    Bakker, DJ, Niinikoski, J 1996Chronic hyperbaric oxygen therapy indications—final reportOriani, GMarroni, AWattel, F eds. Handbook of Hyperbaric MedicineSpringer-VerlagMilan485507Google Scholar
  11. 11.
    Baroni, G, Porro, T, Faglia, E,  et al. 1987Hyperbaric oxygen in diabetic gangrene treatmentDiabetes Care108186PubMedGoogle Scholar
  12. 12.
    Oriani, G, Meazza, D, Favales, F,  et al. 1990Hyperbaric oxygen in diabetic gangreneJ. Hyperb. Med.5171175Google Scholar
  13. 13.
    Zamboni, WA, Wong, HP, Stephenson, LL,  et al. 1997Evaluation of hyperbaric oxygen for diabetic wounds: a prospective studyJ. Hyperb. Med.24175179Google Scholar
  14. 14.
    Faglia, E, Favales, F, Aldeghi, A,  et al. 1996Adjunctive systemic hyperbaric oxygen therapy in treatment of severe prevalently ischemic diabetic foot ulcersDiabetic Care1913381343Google Scholar
  15. 15.
    Kalani, M, Jörneskog, G, Nazanin, N,  et al. 2002Hyperbaric oxygen (HBO) therapy in the treatment of diabetic foot ulcers. Long-term follow-upJ. Diabetes Complications16153158CrossRefPubMedGoogle Scholar
  16. 16.
    Fourth Consensus Conference of the European Committee on Hyperbaric Medicine1999Hyperbaric oxygen in the management of foot lesions in diabetic patientsDiabetes Nutr. Metab.124748Google Scholar
  17. 17.
    Mathieu, D 2002Working group “HBO and diabetic foot lesion” of COST B14 action. Hyperbaric oxygen therapy in the treatment of diabetic foot lesions. A randomized controlled prospective studyEur. J. Underwater Hyperb. Med.365Google Scholar
  18. 18.
    Brakora, MJ, Sheffield, PJ 1995Hyperbaric oxygen therapy for diabetic woundsClin. Pod. Med. Surg.12105117Google Scholar
  19. 19.
    Mathieu, D, Nevière, R, Wattel, F 1996Transcutaneous oximetry in hyperbaric medicineOriani, GMarroni, AWattel, F eds. Handbook on Hyperbaric MedicineSpringer-VerlagMilan686698Google Scholar
  20. 20.
    Fife, CE, Buyukcakir, C, Otto, GH,  et al. 2002The predictive value of transcutaneous oxygen tension measurement in diabetic lower extremity ulcers treated with hyperbaric oxygen therapy: a retrospective analysis of 1144 patientsWound Rep. Reg.10198207CrossRefGoogle Scholar
  21. 21.
    Hammarlund, C, Sundberg, T 1994Hyperbaric oxygen reduced size of chronic leg ulcers: a randomized double-blind studyPlast. Reconstr. Surg.93829833PubMedGoogle Scholar
  22. 22.
    Zamboni, WA 1996Applications of hyperbaric oxygen therapy in plastic surgeryOriani, GMarroni, AWattel, F eds. Handbook of Hyperbaric MedicineSpringer-VerlagMilan441483Google Scholar
  23. 23.
    Strauss, MB 1994Crush injury and other traumatic peripheral ischemiasKindwall, EP eds. Hyperbaric Medicine PracticeBest Publishing CompanyFlagstaff AZ525549Google Scholar
  24. 24.
    Mathieu, D, Wattel, F, Bouachour, G,  et al. 1990Post traumatic limb ischemia: prediction of final outcome by transcutaneous oxygen measurements in hyperbaric oxygenJ. Trauma30307314PubMedGoogle Scholar
  25. 25.
    Strauss, MB, Hargens, AR, Gershuni, DH,  et al. 1983Reduction of skeletal muscle necrosis using intermittent hyperbaric oxygen in model compartment syndromeJ. Bone Joint Surg.65A656662Google Scholar
  26. 26.
    Merkesteyn, JPR, Bakker, DJ, Kooijman, R 1996RadionecrosisOriani, GMarroni, AWattel, F eds. Handbook of Hyperbaric MedicineSpringer-VerlagMilan387401Google Scholar

Copyright information

© Société Internationale de Chirurgie 2004

Authors and Affiliations

  1. 1.Department of SurgeryUniversity of TurkuTurkuFinland

Personalised recommendations