Beneficial Effect of Hyperbaric Oxygen Therapy on an Open Abdominal Laparostomy Wound

Abstract

Hyperbaric oxygen therapy (HBOT) is the exposure to 100% oxygen at pressures greater than atmospheric pressure. Currently there are several approved applications, and indications for the use of HBOT are increasing. HBOT has been successfully used as adjunctive therapy for wound healing. A 50-year-old female presented at the surgical emergency department with bile-stained discharge from the port site of a laparoscopic cholecystectomy performed 4 days previously. Exploratory laparotomy revealed two perforations in the ileum and edema of the bowel. An ileostomy was constructed, but the abdomen was not closed because of the edematous bowel, and a Bogota bag was placed over the bowel to cover the laparostomy. The abdominal wound was extensive, with exposed loops of bowel. When the wound failed to heal, HBOT was first given on the 10th post-operative day (POD). She had a total of 4 sessions of HBOT with 100% oxygen under 2.5 atmospheres absolute pressure for 60 minutes on PODs 10, 12, 14 and 16. Healthy granulation tissue started appearing over the bowel and wound edges, and impressive wound healing occurred with only 4 60-minute sessions of HBOT. The patient was discharged on POD 20. The application of HBOT for cases of burst abdomen has not been previously documented. This is the first report of its beneficial effect in a single case with an extensive open laparostomy wound. Further studies need to be conducted in order to confirm the therapeutic effect of HBOT on open abdominal wounds.