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Update on hyperbaric oxygen therapy in burn treatment

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Summary

Hyperbaric oxygen therapy (HBOT) has been shown to improve tissue hypoxia, neovascularization and ischemia reperfusion injury and reduce pathologic inflammation in various clinical settings and was proposed to be a game changer in treatment of burns. Improved and faster wound healing as well as a reduction of morbidity and mortality after thermal and concomitant carbon monoxide poisoning are expected. In defiance of the observed benefits for burn wounds and carbon monoxide poisoning in animal models and few randomized controlled trials there is an ongoing controversy regarding its use, indications and cost effectiveness. Furthermore, the use of HBOT, its indications and the evidence behind its efficiency are still widely unknown to most physicians involved in the treatment of burn patients. Therefore, a review of the up to date evidence-based literature was performed with a focus on available data of HBOT in burn care, to elaborate its use in acute thermal injury and carbon monoxide intoxication. Although beneficial effects of HBOT seem very likely insufficient evidence to support or disprove the routine use of HBOT in the treatment of burn care was found. Although difficult to carry out because of the high interindividual variability of burns and chronic wounds, the need for larger high-quality prospective randomized double-blinded controlled multicenter trials are necessary to be able to evaluate useful applications, expense and cost-efficiency of HBOT for burn care.

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, Medical University of Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

    Laurenz Weitgasser MD & Christine Radtke MD PhD

  2. Department of Anesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Währinger Gürtel 18–20, 1090, Vienna, Austria

    Gerald Ihra MD, Bruno Schäfer MD & Klaus Markstaller MD

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L. Weitgasser, G. Ihra, B. Schäfer, K. Markstaller, and C. Radtke hereby officially declare that they have no conflict of interest in any form, financial or other and that the manuscript is original and written to the best of their knowledge and has not been submitted anywhere else.

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Weitgasser, L., Ihra, G., Schäfer, B. et al. Update on hyperbaric oxygen therapy in burn treatment. Wien Klin Wochenschr 133, 137–143 (2021). https://doi.org/10.1007/s00508-019-01569-w

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