title: Angiogenesis in necrotic ulcers treated with hyperbaric oxygen.
abstract: Necrotic/gangrenous wounds lack adequate blood supply and develop further vascular damage from either reperfusion injury or oxygen toxicity when exposed to oxygen at the wrong pressures. A prospective randomized study was performed to confirm the efficacy of topical hyperbaric oxygen at 1.004 to 1.013 atmospheres (THOT) in stimulating angiogenesis and healing of necrotic/gangrenous wounds. Participants included 40 inpatients (79 ulcers) recruited over 12 months who were assigned to treatment by either THOT or standard wound care (SWC). The results showed that 90% of the wounds healed in the THOT group compared to 22% in the SWC controls. Repeated measures ANOVA on log (ulcer size at 4 weeks) showed a significant group by time interaction, F(1,55) = 68.2, P < 0.0001. The size of ulcers (at 4 weeks) was significantly smaller with THOT, but larger with SWC. Capillary density/hpf (high power field) was significantly higher in THOT wounds than in SWC wounds (P < 0.001). It was concluded that THOT is effective in stimulating angiogenesis with enhanced healing of necrotic wounds.
authors.affiliation: Department of Medicine, VA Greater Los Angeles Healthcare System (Sepulveda), UCLA San Fernando Valley Program.
authors.forename: M C
authors.initials: MC
authors.lastname: Heng
authors.forename: J
authors.initials: J
authors.lastname: Harker
authors.forename: G
authors.initials: G
authors.lastname: Csathy
authors.forename: C
authors.initials: C
authors.lastname: Marshall
authors.forename: J
authors.initials: J
authors.lastname: Brazier
authors.forename: S
authors.initials: S
authors.lastname: Sumampong
authors.forename: E
authors.initials: E
authors.lastname: Paterno Gomez
mesh_terms: D000368:Aged; D017719:Diabetic Foot / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D009336:Necrosis; D018919:Neovascularization, Physiologic; D011446:Prospective Studies; D014945:Wound Healing