RESEARCH PAPER
Treatment of lower limb trophic ulcers using hyperbaric oxygenation
 
More details
Hide details
1
Department of Trauma Surgery and Emergency Medicine, Medical University, Lublin, Poland
 
2
Department of Internal Medicine, Medical University, Lublin, Poland
 
 
Corresponding author
Andrzej Prystupa   

Department of Internal Medicine, Medical University, Lublin, Poland
 
 
J Pre Clin Clin Res. 2014;8(1):44-47
 
KEYWORDS
ABSTRACT
Introduction:
Lower limb venous ulcers affect approximately 1–1.3% of the population and constitute the most dangerous and distressing complication related to chronic venous insufficiency. Although the issue of trophic ulcer pathogenesis remains unclear, it is beyond doubt that adequate oxygen delivery to the tissues is the key factor in wound healing. Recent technological advances allow the use of hyperbaric oxygenation in patients with hard-to-heal wounds.

Objective:
The aim of this study is to present own results regarding the use of hyperbaric oxygenation in a group of 37 patients with lower limb trophic ulcers of vascular etiology, who were treated in the Clinic of Trauma Surgery and Emergency Medicine in Lublin.

Material and Methods:
The study involved 37 patients, 22 women and 15 men, aged 42–84 years, treated in the Clinic of Trauma Surgery and Emergency Medicine in Lublin in 2011–2012. The group treated in the Clinic included 30 patients with venous ulcers (the largest group) as well as 3 patients with arterial ulcers and 4 patients with mixed arterial/venous ulcers. Patients were referred for further treatment in the Hyperbaric Centre of the District Hospital in Łęczna. The treatment included 20–30 compression sessions at a pressure of 2.5 ATA 1.6 kg/cm in a HiperTech Zyron 12 Multiplace chamber. A single session lasted 90 minutes.

Results:
Hyperbaric chamber treatment resulted in complete wound healing in 22 patients (more than 59%). Partial wound healing (half of the surface area) was achieved in 13 patients (35%). Lack of wound healing was observed in 2 patients (5%) with arterial and mixed ulcers.

REFERENCES (23)
1.
Goldman MP, Weiss RA, Bergan JJ. Diagnosis and treatment of varicose veins; a review. J Am Acad Dermatol. 1994; 31: 393.
 
2.
Junger M, Hahn V, Bort S. Significance of cutaneous microangiography for the pathogenesis of dermatitis in venous congestion due to chronic venous insufficiency Wien Med Wschr. 1994; 144: 206.
 
3.
Polański J. Przewlekła niewydolność żylna w kończynach dolnych. Med po dypl. 1998; 7(2), 17–20 (in Polish).
 
4.
Skillman JJ. Venous leg ulcer W. chronic problem wounds R. Rudolph, J.M. Little, Brown and Co. Boston 1983: 113.
 
5.
Wojszwiłło-Geppert E, Włodarkiewicz A, Paliszewski J. Patogeneza owrzodzeń żylnych goleni. Przegląd Dermatologiczny 1997; 84: 271–277 (in Polish).
 
6.
Goldman MP, Fronek A. Consensus paper on venous leg ulcer. J Dermatol Oncol. 1992; 18: 592.
 
7.
Beele H, Naeyaert JM, Goeteyn M. Repeated cultured epidermal allograft in the treatment of chronic leg ulcer of various origins. Dermatologica 31: 183, 1991.
 
8.
Cornawall JV, Dore CJ, Levis JD. Leg ulcers; epidemiology and aetiology Br J Surg. 1986; 73: 693–696.
 
9.
Franks PJ, Bosanquet N, Connolly M, Oldroyd MI, Moffatt CJ, Greenhalgh RM, McCollum CN. Venous ulcer healing; effect of socioeconomic factors in London. J Epidemiol. Community Health 49(4), 1995: 385–388.
 
10.
De Plama RG, Kowallek DL. Venous ulceration: a cross-over study from nonoperative to operative treatment. J Vasc Surg. 24(5), 1996: 788–792.
 
11.
Pierik EG, Wittens CH, Van urk H. Subfascial endoscopic ligation in the treatment of incompetent perforating veins. Eur J Endovasc Surg. 1995; 9(1): 38–41.
 
12.
Dunn RM, Fuden GM, Walton RL. Free flap valvular transplantation for refractory venous ulceration. J Vasc Surg. 1994; 19: 525.
 
13.
Amann-Vesti BR, Ruesch C, Gizelmann G, Hafner J, Koppensteiner R. Micro Angiography of swplint-skin grafts in venous ulcers. DermatolSurg. 2004, 30(3): 399–402.
 
14.
Goodwin C, Heppenstall R. The effect of chronic hypoksia on wound healing. Advances in Experimental Med Biol. 1997; 94: 669–672.
 
15.
Cornwall JV, Dore CJ, Lewis JD. Leg ulcers: epidemiology and etiology. Br J Surg. 1986; 73: 693–696.
 
16.
Gourdin FW, Smith J. G. Jr. Ethiology of venous ulceration. South Med J. 1993; 86: 1142.
 
17.
Kawecki M, Sieroń A, Glik J, Nowak M, Szymańska B, Knefel G. Rola hiperbarii tlenowej w leczeniu chirurgicznym troficznych owrzodzeń podudzi spowodowanych przewlekłą niewydolnością żylną. Borgis – Balneologia Polska 2006; 3: 150–155 (in Polish).
 
18.
Kawecki M. i wsp. Terapia tlenem hiperbarycznym w centrum leczenia oparzeń. Doświadczenia własne. Balneologia Polska. 2006; 4 (in Polish).
 
19.
Kawecki M. i wsp. Aktualne wskazania i możliwości zastosowania hiperbarycznej terapii tlenowej. Balneologia Polska. 2006; 4 (in Polish).
 
20.
Deepika K, Myers RA, Cooley RA. Cardiovascular effects of hyperbaric oxygen in septic patients. Undersea Biomed Res. 1982; 9: 44.
 
21.
Nylander G, Lewis D, Nordstrom H, Larson J. Reduction of postischemicedema with hyperbaric oxygen. PlastReconstrSurg. 1985;. 76: 596–603.
 
22.
Davidson JD, Mustoe TA. Oxygen in wound healing: more than a nutrient. Wound Repair Regen. 2001; 9: 175–177.
 
23.
Mandell G. Bactericidal activity of aerobic and anaerobic polymorphonuclear neutrophils. Infect Immun. 1974; 9: 337–341.
 
eISSN:1898-7516
ISSN:1898-2395
Journals System - logo
Scroll to top