Hyperbaric
oxygen may be associated with some reduction in wound size, exudate and
hyperaemia following a standard injury model.
Clinical Bottom Line:
1.
The addition of hyperbaric oxygen treatment in this model of a burn
injury was associated with a reduction of wound size, exudate and hyperaemia
on day 2 only.
Appraised
by: Mike Bennett, Dept of Diving and
Hyperbaric Medicine, Prince of Wales Hospital
Sydney; Thursday, 25 March 1999
Clinical
Scenario: A patient with thermal burns
presented for treatment, we wondered if adding hyperbaric oxygen to the
treatment would improve outcome.
Three-part
Question: For patients with thermal
burns, does the addition of hyperbaric oxygen to the standard treatment result
in any improvement in the rate of healing?
Search
Terms: burns
The
Study:
Double-blinded concealed
randomised controlled trial with intention-to-treat.
Healthy, non-smoking volunteers
with a standard wound inflicted on the forearm.
Control group (N =6;6 analysed):
Blister formed by suction, de-roofed and irradiated with UV light in a standard
way. Wound then covered with hydrocolloid dressing renewed daily. Sham
hyperbaric treatment started within 2 hours, twice daily for three days, at
2.4ATA on 8.75% oxygen for three thirty minute periods separated by 10 minute
air breaks. 100% oxygen decompression.
Experimental group (N =6;6
analysed): As above, but hyperbaric sessions involved breathing of 100% oxygen
for three thirty minute periods separated by 10 minute air breaks.
The
Evidence:
Non-Event
Outcomes
Time to outcome
Control group HBO group
P-value
Hyperaemia
(perfusion
units)
Day 2
25.0
14.4
0.05
exudate/day
(g)
Day
2
0.30
0.19
0.03
Wound
size (cm2)
Day 2
0.95
0.61
0.04
Comments:
1. Statistically significant
differences on day two only.
2. Possibly inappropriate use of
statistical analysis by use of multiple one-tail t-tests at times that may not
have been a priori.
3. Clinical relevance unclear.
Expiry date: September 2003
References:
1. Niezgoda JA, Cianci P, Folden BW, Ortega RL, Slade JB,
Storrow AB. The effect of hyperbaric oxygen therapy on a burn wound model in
human volunteers. Plastic and Reconstructive Surgery 1997; 99:1620-1625.
