A chronic injury is one that has not healed after a reasonable period of time. Normally this occurs because in the lesion there is hypoxia and ischemia.
Application in HBOT in chronic wounds:
– Decubitus bedsores.
– Arterial or venous ulcers.
– Diabetic foot.
– Injuries induced by radiotherapy.
– Chronic wounds.
Chronic wounds are caused by several causes such as inadequate circulation produced by peripheral vascular diseases or venous stasis, or by an increase in pressure on some affected areas. In addition, fibroblasts in patients with diabetes or venous insufficiency demonstrate a decrease in their ability to proliferate and changes associated with cell aging. In these wounds lack growth factors that are fundamental in the stimulation of cell migration, proliferation and the formation of the extracellular matrix.
Oxygen plays a very important role in the repair mechanisms of the lesions, since the low partial pressure of oxygen in the tissues is what usually causes the failure of healing. Providing oxygen to chronic injuries can accelerate healing that is usually very slow and lengthens over time, as well as prevent the complications of the process.
Different types of cells and chemical intermediates intervene in the healing process:
The platelets are the first to reach the injured area, and later appear the cells of the immune system that localize the tissues and the cells of the dermis responsible for the secretion of the elastin and collagen fibers, as well as the glycosaminoglycans that they form the support matrix of the dermis.
Once in the area, they organize and begin to produce proteins that regulate the function of the cells they produce on other types of cells. Then there is an increase in the synthesis of collagen and angiogenesis, appearing the granulation tissue to finally achieve healing.
– Accelerates the healing of wounds.
– Help in the regeneration of damaged tissues.
– Enhances the effect of some antibiotics.
– Increases the activity of fibroblasts.
– Increases the synthesis of collagen.
– Improves antimicrobial defense.
– Prevents necrosis.
– Increases tissue partial pressure of O2 by correcting hypoxia.
The administration of oxygen in wounds improves the chances of scarring foot ulcers related to diabetes and can reduce the number of major amputations in patients with diabetes who have chronic foot ulcers. In addition, this method of administering oxygen in wounds can reduce the size of ulcers caused by venous insufficiency of the legs, achieving 80% of the total healing and reducing the chances of relapse.
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