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Invited Critique
March 2003

Hyperbaric Oxygen for Treating Wounds—Invited Critique

Arch Surg. 2003;138(3):280. doi:10.1001/archsurg.138.3.280

Wang et al summarized the available literature on the use of HBO for wound treatment. They took care to include only reports that included a minimum of 5 patients and also conducted a survey of experts in the field to identify any potential studies not detected by their literature search. They come to the proper conclusion that there is no consensus based on the literature for treatment with HBO.

This study highlights an important point in the translation of basic scientific knowledge to actual bedside treatment. A number of in vitro studies have indicated that cells involved in the process of wound repair are dysfunctional when placed in a hypoxic environment. The direct translation of these data was that oxygen delivery to poorly healing wounds was compromised and that improved oxygen delivery might allow those wounds to heal. An added corollary is that in a disease process where a lack of oxygen is required for progression, ie, necrotizing infections, the use of HBO might limit spread and aid recovery. However, Wang et al has clearly demonstrated that there are no clear guidelines for HBO therapy.

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