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Hyperbaric oxygen therapy enables pain reduction and healing in painful chronic wounds, including in calciphylaxis
E Pathault1, S Sanchez2, B Husson1
1Department of Dermatology, Reims University Hospital, Reims, France.
Insights
Hyperbaric oxygen therapy (HBOT) significantly reduced pain and strong opioid use in patients with chronic wounds, excluding diabetic foot ulcers. This adjuvant therapy also promoted wound healing in most participants.
Area of Science:
- Wound healing research
- Hyperbaric medicine
- Pain management
Background:
- Hyperbaric oxygen therapy (HBOT) is recognized for its benefits in wound healing, particularly for diabetic foot ulcers.
- Evidence for HBOT's efficacy in other chronic painful wounds remains less explored.
Purpose of the Study:
- To investigate the effectiveness and safety of HBOT for chronic painful wounds beyond diabetic foot ulcers.
- To assess changes in pain levels and analgesic consumption post-HBOT.
Main Methods:
- A retrospective monocentric study included patients with chronic wounds and pain unresponsive to analgesics from 2008-2021.
- Pain was evaluated by analgesic consumption changes up to 12 months post-HBOT.
- Wound healing status (complete or partial) was also recorded.
Main Results:
- Eighteen patients with various chronic wounds (calciphylaxis, vasculitis, hypertensive leg ulcers, etc.) were analyzed.
- 15 out of 18 patients (83.3%) showed reduced analgesic needs, including a significant decrease in strong opioid use (72.2% to 11.1%).
- Local wound improvement was observed in 83.3% of patients within a median of 3.9 months.
Conclusions:
- HBOT serves as an effective adjuvant therapy for chronic painful wounds of diverse origins.
- HBOT significantly decreases the reliance on strong opioids, which is crucial given frequent adverse reactions.
- Further prospective, controlled studies are recommended to validate these findings.
Background:
The effects of hyperbaric oxygen therapy (HBOT) on wound healing have been demonstrated mainly in diabetic foot ulcer.
Objectives:
To study the efficacy and safety of HBOT in chronic painful wounds, excluding diabetic foot ulcers.
Methods:
From 2008 to 2021, patients with chronic wounds showing no clinical improvement for more than 1 month, who were in pain despite the use of level 2 or 3 analgesics, and who had undergone HBOT sessions, were included in a monocentric retrospective study. The primary objective was to evaluate the course of pain by studying analgesic consumption before and up to a maximum of 12 months after HBOT. Achievement of complete or partial healing was also recorded.
Results:
Eighteen patients with calciphylaxis (n = 6), vasculitis (n = 4), hypertensive leg ulcer (n = 3), mixed ulcer (n = 3), Buerger's disease (n = 1), and livedoid vasculitis (n = 1) were included. Decrease in analgesic step, dose or number was noted in 15 of 18 patients (83.3%) within a median time of 3.5 (0.3-12) months, with a significant decrease in strong opioid use (72.2% before vs. 11.1% after, p = 0.005), as well as local improvement in 15 of 18 patients (83.3%) within a median time of 3.9 (1-10.3) months.
Conclusion:
HBOT as an adjuvant in chronic painful wounds of various etiologies allows a significant reduction in strong opioid consumption. This finding in a population with frequent adverse reactions to opioids requires demonstration in prospective and controlled studies.
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