Oxygen Hyperbaric Pressure Therapy (OHPT) for Decubitus Ulcers

Abstract

Aim: Although oxygen hyperbaric pressure therapy (OHPT) for intractable ulcers is covered by national insurance, few studies have reported its use in the treatment of decubitus ulcers. In this study, we used OHPT as part of conservative treatment, and obtained good results.Methods: Five inpatients received a 60‐min session of 100% oxygen in a Hyperbaric Oxygen ChamberR(Kawasaki Engineering Co., Kobe, Japan) at 2 ATA for 10 days. The clinical response was evaluated by four parameters, the difference in the area of ulcer wounds before and after treatment, changes in inflammatory responses, state of wound infection, and histological findings.Results: OHPT was effective in reducing the area of ulcer wounds in four patients. Three patients, in whom blood tests had shown inflammatory responses (increases in WBC and CRP) before treatment, showed improvement. Two patients, in whom wound cultures were positive for MRSA, became negative after treatment. However, the patients varied in granulation tissue proliferation during treatment. The possible mechanisms underlying these changes were, first, improvement of tissue hypoxia by hyperbaric oxygen supply to ischemic tissue, leading to the above‐described reduction in wound area and improvement in inflammatory responses, and second, inhibition of bacterial growth due to an increase in active oxygen species, leading to the disappearance of wound infection.Conclusions: The results of this study suggest that OHPT is a very useful option in the conservative treatment of decubitus ulcers.