The increase of oxygen by facilitated diffusion using oxygen binding and releasing molecules.
It is well known that wound healing is accompanied by an increase in metabolism in the skin tissue and therefore requires considerably more oxygen than intact skin. In the different phases of wound healing, numerous biochemical and cellular processes are highly dependent on a sufficient supply of oxygen.
Therefore, it makes sense that the status of the oxygen supply to a wound represents an important determinant for the course of healing.
As oxygen plays a crucial role in wound healing, supplying additional oxygen to the chronic wounds may help promote healing.
Any topical oxygen therapy needs to overcome two major intrinsic issues:
- Diffusion between the gas phase of oxygen and the solid or liquid phase of the skin and the wound exudate, which serve as barriers
- Movement of oxygen within the liquid phase of the wound bed to the cells that require the oxygen, through transfer and diffusion processes.
In this situation, the improvement of oxygen content in the wound area by topical approaches should have a beneficial impact on physiological processes in wounds. Topical approaches aim to generate a local increase of oxygen concentration at the wound site.
Unlike systemic oxygen therapy, topical oxygen does not rely on an (impaired) vascular system to deliver the oxygen to the wound site. It also has reduced risks compared to systemically increasing oxygen via hyperbaric oxygen therapy.
During the last two decades, results of various case studies and clinical trials suggest that the local oxygen therapies are promising options for enhancing wound healing. These results are supported by several experimental and clinical studies that have highlighted the key role of oxygen in wound healing in general and specifically in patients with chronic wounds. Improving the oxygen supply at the wound should be an essential and important part of wound management.
All the described topical oxygen therapies aim to improve the oxygen supply to the hypoxic area of the wounds so that rapid skin regeneration can take place.
The clinical results achieved with these methods indicate that significant benefits are possible over standard care alone. The evidence base shows successful healing outcomes when standard care has failed to achieve an adequate healing response. As for many other products used in wound care management, the clinical evidence for the efficacy of topical oxygen-based treatment is still based largely on case reports and small clinical trials.
Topical oxygen therapy approaches are not yet widely used in the wound care community anywhere in the world. Growing evidence of its effectiveness suggests it has the potential to form a regular part of adjunctive therapies in treatment regimens to speed up healing of chronic wounds.