title: The Mechanism of Hyperbaric Oxygen Therapy in the Treatment of Chronic Wounds and Diabetic Foot Ulcers.
abstract: Non-healing wounds are a growing public health concern, and more than $25 billion per year in the US are spent caring for patients with chronic wounds. Many of these patients are referred to specialized wound centers, where hyperbaric oxygen therapy (HBO2T) has become a mainstay in healing wounds, especially diabetic foot ulcers (DFU). However, it is costly, with a typical course of therapy running into the tens of thousands of dollars. Presently, as many as 30-40% of DFU patients with Wagner's Grade 3 and 4 ulcers treated with HBO2T fail to heal by 24 weeks. Unfortunately, the patient will have already received lengthy therapy (30-60 daily treatments over 6-10 week time period) before having the wound deemed non-responsive. Currently, practitioners employ a combination of clinical markers, diagnostic testing and a four-week preliminary healing response, but this approach is inaccurate and delays definitive identification of HBO2T responder and non-responder phenotypes.
authors.affiliation: Warren Alpert Medical School, Brown University.
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Johnston
authors.affiliation: Warren Alpert Medical School, Brown University.
authors.forename: Austin Y
authors.initials: AY
authors.lastname: Ha
authors.affiliation: Department of Bioengineering, Brown University.
authors.forename: Bielinsky
authors.initials: B
authors.lastname: Brea
authors.affiliation: Warren Alpert Medical School, Brown University; Department of Plastic and Reconstructive Surgery, Rhode Island Hospital.
authors.forename: Paul Y
authors.initials: PY
authors.lastname: Liu
mesh_terms: D002908:Chronic Disease; D017719:Diabetic Foot / Q000378:metabolism / Q000628:therapy; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D014945:Wound Healing / Q000502:physiology*; D014947:Wounds and Injuries / Q000378:metabolism / Q000628:therapy
keywords: Chronic wounds; Diabetic foot ulcer; Hyperbaric oxygen therapy; Molecular mechanism