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Oxygen Therapy in Wound Healing

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Local Wound Care for Dermatologists

Part of the book series: Updates in Clinical Dermatology ((UCD))

Abstract

Background: Oxygen is mandatory for almost all wound healing processes, in particular the processes of cell regeneration and angiogenesis. As it is lacking in chronic and even acute wounds, oxygen substitution seems to be an obvious adjuvant tool. In vitro and in vivo tests showed improvement of microenvironment essential for the onset of appropriate healing processes.

Oxygen substitution can be delivered in the form of hyperbaric oxygen therapy (HBOT) or topical oxygen therapy (TOT). The latter can be applied in the form of continuous or cyclic pressurized oxygen therapy, continuous non-pressurized oxygen, oxygen containing wound dressings, and oxygen transferring sprays/solutions or gels. There are numerous studies, case series, and other publications recommending the application of oxygen therapy. In contrast to HBOT, randomized controlled clinical trials are rare for the majority of TOT.

Conclusions: Oxygen therapy has raised expectations due to known pathophysiology and in vitro tests. Nonetheless, integration into routine practice is lacking either due to complexity for HBOT procedure or due to fragmentary or even contradictory clinical data for some approaches of TOT. However, simplicity of application, safety, cost-effectiveness, impressive case studies, and in vitro tests justify the application of many topical oxygen therapies in clinical routine. Nevertheless, further clinical controlled trials in a randomized setting are warranted.

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Abbreviations

ATA:

Atmosphere absolute

ATP:

Adenosine triphosphate

CVI:

Chronic venous insufficiency

DFU:

Diabetic foot ulcer

EPC:

Endothelial progenitor cells

HBOT:

Hyperbaric oxygen therapy

HIF:

Hypoxia-inducible factor

IL:

Interleukin

MOIST:

Moisture balance, Oxygen balance, Infection control, Support, Tissue management

NO:

Nitric oxide

NOX:

NADPH oxidase

NOX-2:

NADPH oxidase 2

PAD:

Peripheral arterial disease

PAOD:

Arterial wounds associated with peripheral arterial occlusive disease

PVD:

Peripheral vascular disease

ROS:

Reactive oxidative species

ROS:

Reactive oxygen species

TCOM or TCPO:

Transcutaneous oximetry

TIME:

Tissue removal, Infection control, Moisture balance, Edge advancement

TNF:

Tumor necrosis factor-alpha

TOT:

Topical oxygen therapies

VEGF:

Vascular endothelial growth factor

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Authors and Affiliations

  1. Department of Dermatology, University Hospital Zurich, Zurich, Switzerland

    Marjam J. Barysch & Severin Läuchli

  2. Dermatologic Centre Zurich, Zurich, Switzerland

    Severin Läuchli

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  1. Marjam J. Barysch
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Correspondence to Severin Läuchli .

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Editors and Affiliations

  1. Division of Dermatology, Department of Medicine, Women’s College Hospital, University of Toronto, Toronto, ON, Canada

    Afsaneh Alavi

  2. Department of Dermatology, University of San Francisco, San Francisco, CA, USA

    Howard I. Maibach

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Barysch, M.J., Läuchli, S. (2020). Oxygen Therapy in Wound Healing. In: Alavi, A., Maibach, H. (eds) Local Wound Care for Dermatologists. Updates in Clinical Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-030-28872-3_12

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  • DOI: https://doi.org/10.1007/978-3-030-28872-3_12

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