Transdermal Continuous Oxygen Therapy as an Adjunct for Treatment of Recalcitrant and Painful Wounds

Abstract

Oxygen has an undisputed role in wound healing. On a cellular level, oxygen impacts collagen production and development through its effects on enzymes. As such, oxygen is critically important for angiogenesis, the production of granulation tissue, as well as resistance to infection. Adequate delivery of oxygen to the wound tissue is vital for optimal healing. Historically, there have been multiple vehicles utilized to deliver oxygen in order to enhance healing. Two examples include hyperbaric oxygen and non-hyperbaric oxygen filled polyethylene or plastic bags. Both are used intermittently. Additionally, systemic delivery by nasal cannula has been utilized which can be monitored by digital pulseoximetry. Transcutaneous oxygen has been injected topically to enhance ligament healing as well as topically for surface wound healing. A new technology: Transdermal Continuous Oxygen Therapy (TCOT) is another delivery system which provides a flow of continuous pure oxygen directly to the wound bed. The authors present a series of 4 case presentations where this new technology was utilized to treat severe wounds in 4 separate patients. All wounds had been recalcitrant to multiple treatment modalities and each had a significant component of pain. The results were satisfactory in that all wounds healed completely, with the additional benefit of complete reduction in pain