PRESSURE SORES AND NON-HEALING WOUNDS 

Non-healing or problem wounds are wounds that have failed to proceed through the normal healing process in an orderly sequence and have failed to close-up or heal properly. (Generally deemed a problem wound if not healed within 30 days). Wounds don’t heal for a variety of reasons – a loss of blood supply or insufficient oxygen supply to the wound and surrounding tissue, there is too much pressure on the wound because of swelling and excess fluid, or else the cause of the wound keeps repeating (eg pressure ulcers or bed sores). People who are bedridden, use a wheelchair or are unable to change their position are at risk of developing a pressure sore (bed sore).

On a cellular level the rate at which a normal wound heals is dependent on the amount of oxygen available. HBOT maximises oxygen delivery and increases wound blood flow by accelerating new blood vessel formation, particularly where there is minimal or insufficiently blood flow. Doctors recommend regular Hyperbaric Oxygenation sessions to people with non-healing wounds, bed sores because the sessions can improve the immune response, clear infection, enhance tissue growth (stem cell production) and improve blood vessel growth (Angiogenesis) providing oxygen to the tissue surround the wound and the wound itself, and speed the rate of healing for the wound. Reperfusion injuries such as crush injuries have also been shown to benefit from HBOT. The majority of studies in this area focus on severe pressure sores and non-healing wounds, however the mechanism of healing and the impact is the same no matter the size or severity of the wound. Studies have shown in some instances, Hyperbaric Oxygenation if used as an early intervention can prevent the need for surgery even including amputation.

FAILED OR SLOW HEALING SKIN GRAFTS AND FLAPS 

A skin graft is the relocation of a portion of the skin without its blood supply to a new site on the body whereas a flap refers to the relocation of one or more tissue components including skin, deeper tissue, muscle and pieces of bone moved with its blood supply. Skin grafts and flaps are commonly required in reconstructive/plastic surgery.

Blood supply to the skin graft or flap can be impaired causing poor healing. A skin graft is used for large open fractures to help close the wound, other large wounds or where the skin has been surgically removed – due to cancer or burns. A flap is required when the wound or area that has lost tissue is too large for the edges to be brought together directly (eg stitched up or otherwise closed). The flap covers the depth and surface of the wound.

Trials also show that preoperative or postoperative Hyperbaric Oxygenation sessions can help improve the survival rate of skin grafts and free flaps. For these skin grafts or flaps to be successful, they need a healthy transplant site with a sufficient oxygen supply. If the wound site where the skin graft or flap is being transplanted doesn’t have enough oxygen, the likeliness of it failing is very high.

OxyGeneration before a procedure can help to prepare the wound site and improve the blood flow and oxygen levels in the receiving area.

OxyGeneration may also be used after the procedure as it may improve the chances of survival of the graft or flap. It does this by reducing oxygen deprivation and likeliness of infection and enhancing fibroblast function (connective tissue) and collagen synthesis.

HBOT has been shown to be very effective in salvaging compromised (eg failing or failed) grafts and flaps and can help maximize the viability of the compromised tissue thereby reducing the need for regrafting or repeat flap procedures. Studies have shown the efficacy of Hyperbaric Oxygenation on enhancement of flap and graft survival in a variety of experimental and clinical situations. In practical terms this means that people who have HBOT after receiving a skin graft or skin flap are more likely to see successful results. The research and studies focus on failed or slow healing grafts and skin flaps, however, if an individual wishes to give their injury the best possible chance for recovery HBOT may be able to provide that extra assistance. OxyGeneration engages collaboratively with other medical professionals to coordinate on best approach and practice in relation to clients.

Burn patients often require skin grafting. There can be complications with the receiving tissue, particular due to the damage that burns cause to the blood circulation in tissue. The burn damage impedes the blood supply, and in turn the oxygen supply to the site of the injury which can make it difficult for the skin graft to survive. Hyperbaric Oxygenation increases new blood vessel growth, thus improving blood supply to compromised areas. The increased oxygen-carrying capacity of the plasma also helps prevent the tissue bordering the burn recover from the trauma. HBOT also helps relieve fluid trapped around the injury (localized edema), which decreases the pressure on the tissue and increases blood flow. Burn patients are also at high risk of developing infections. Hyperbaric Oxygenation helps lower infection rates. HBOT as an adjunct can help the survival and success of a skin graft or skin flap. OxyGeneration works pro-actively with medical professionals to coordinate on best approach and practice in relation to patients.