Endocrine Abstracts

Introduction: Topical wound oxygen therapy (TWO₂) is therapeutic modality that delivers humidified pressurised O₂ directly to the specific body part to achieve tissue penetration and increased O₂ levels to the open ischaemia wound. O₂ is vital in the synthesis of collagen, enhancement of fibroblasts, angiogenesis, leukocyte function, energy metabolism, and the inhibition of mycrobial growth. TWO₂ therapy has showed effectiveness as an adjunctive therapy for the management of acute and chronic diabetic foot ulcers, venous stasis ulcers, pressure ulcers, and mixed ulcers.

Materials and methods: Five male patients aged 50–77 years with chronic diabetic foot ulcers grade 2A or worse according to the University of Texas wound Classification system (UTI) and ankle–brachial index (ABI) at least 0.5 in the affected limb were treated with TWO₂ 60 min daily, Monday through Friday for 6 weeks. Wound size measuring, microbiological samples, and digital photography of the wound were done once weekly. Wounds were debrided prior to therapy by the vascular surgeon, who assessed the wound every 7–10 days and debrided it if necessary. If infection was present antibiotics were given according to the antibiogram.

Results: Wound area reduced from average 8.86–2.54 cm². Ulcer classification changed from UTI 2-B, 2-C and 2-D to 1-A and 0-A. Infection was absent in all wounds comparing to four infected wounds at the beginning.

Conclusion: Although current studies have shown effectiveness of TWO₂ in treatment of diabetic foot ulcers, there are no specific cost effectiveness studies completed and there have been no studies found that show improved quality of life for patients receiving TWO₂. The most important thing is that there are no standardised protocols for TWO₂. So, randomised control studies are needed to increase the evidence around the use and effectiveness of TWO₂ therapy and to establish optimal parameters for use.