(CR-059) Hyperbaric Oxygen Therapy for post traumatic wounds: A road less travelled

Preksha Rani, MBBS, MS, MCh – Senior Resident, Division of Trauma Surgery and Critical Care, JPN Apex Trauma Center, AIIMS Delhi; Garima Katiyar, MBBS – Junior Resident, Division of Trauma Surgery and Critical Care, JPN Apex Trauma Center, AIIMS Delhi; Sushma Sagar, MBBS, MS – Professor, Division of Trauma Surgery and Critical Care, JPN Apex Trauma Center, AIIMS Delhi; Vennila Bala, M.Sc Nursing – Wound Care Nurse, Division of Trauma Surgery and Critical Care, JPN Apex Trauma Center, AIIMS Delhi; Shijomol Joseph, B.Sc Nursing – Wound Care Nurse, Division of Trauma Surgery and Critical Care, JPN Apex Trauma Center, AIIMS Delhi; Amit Gupta, MBBS, MS – Professor, Division of Trauma Surgery and Critical Care, JPN Apex Trauma Center, AIIMS Delhi; Subodh Kumar, MBBS, MS – Professor, Division of Trauma Surgery and Critical Care, JPN Apex Trauma Center, AIIMS Delhi; Maneesh Singhal, MBBS, MS, MCh – Department of Plastic, Reconstructive and Burns Surgery, All India Institute of Medical Sciences, New Delhi

Introduction: Wounds increase the morbidity and mortality of polytrauma patients and prolong their hospital stay. Oxygen is a well-established prerequisite for wound healing. Hyperbaric oxygen therapy (HBOT) involves intermittent inhalation of 100% oxygen in chambers pressurized above 1 atmosphere absolute (ATA). HBOT promotes wound healing by hyperoxygenation i.e., it increases dissolved oxygen in plasma.

Methods: This is a retrospective analysis of all the consecutive patients who were treated with HBOT as an adjunct to routine wound care from June 2022 to November 2022. Demographic details, wound details and whether the treatment goal (pre-determined by the treating clinician) is achieved or not were recorded.

Results: A total of 68 patients were reviewed, with 73 wounds with a mean age of 32yrs. The number of sessions HBOT ranged from 1 to 30 with a median of 8 sessions. Majority of patients had lower limb wounds (n=41, 60.30%) and acute wound (n= 51, (75.0%). Most patients were amputees with stump complications (n=25, 36.8%). The treatment goal was achieved in 54 patients (79.4%). We could not find any significant association between chronicity wound (p= 0.315), location of wound, etiology (p=0.086), and type of wound (χ2 = 1.582, p = 0.718) on outcomes of HBOT therapy.

Discussion: The role of HBOT in chronic diabetic wound healing was well documented [1] and there is a lack of good-quality evidence of its role in traumatic wounds [2]. However, there is some evidence of its role in complicated acute wounds [3]. In our study, we evaluated various wound characteristics and their effect on outcomes with HBOT. No significant association was found between chronicity of wound or etiology against the outcome.

HBOT as an adjunctive measure can be utilized in traumatic and acute wounds, however, there is a need for larger, well-designed studies to establish its role in post-traumatic wound care.