Predictors for success of hyperbaric oxygen therapy for problematic wounds

Abstract Objective Our aim was to determine the treatment outcome using HBOT for both acute and chronic problematic wounds. Methods This was a case-control study conducted at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand between 2012 and 2017. The inclusion criterion was all patients with either acute or chronic wounds with delayed wound healing treated with hyperbaric oxygen therapy (HBOT). Wound improvement was the primary outcome. Results Eighty-eight patients were included. Sixty-eight patients (77%) had improved wound healing while 20 (23%) had a poor treatment outcome. In the improved wound healing group, the outcome of wound healing was classified into 2 groups: Group 1 – 40 patients (58.8%) experienced wound healing while Group 2 – 28 patients (41.2%) experienced decreased wound size and reduced pain. The factors prognostic for a poor treatment outcome were arterial occlusion (OR 19.667, 95% CI 5.740 - 67.378), diabetes (OR 3.405, 95% CI 1.198 - 9.679), and bone exposure (OR 10.389, 95% CI 2.763 - 39.058). Conclusion Among patients with problematic wounds undergoing HBOT, the factors associated with a poor prognosis were arterial occlusion, DM, and wound with bone exposure.