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OXYGEN POSTERS 103
Transdermal Sustained Oxygen Therapy Promotes Healing of a Chronic Pressure Ulcer in a Patient with Osteomyelitis: A Case Report
Author(s) -
Wilson C.,
Hirsh F.S.,
Schmidt S.P.
Publication year - 2008
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/j.1067-1927.2005.130216g.x
Subject(s) - medicine , oxygen therapy , wound care , granulation tissue , surgery , transdermal , anesthesia , wound healing , antibiotics , microbiology and biotechnology , pharmacology , biology
Clinical Problem: An 89‐year‐old white male presented to his dermatologist with a pressure ulcer on his left medial foot. He was not a surgical candidate (CHF, pacemaker, edema) and not diabetic. Past Management: For 2 years the dermatologist provided standard of care therapies treating the wound with regular debridements and Regranex therapy. The wound remained unhealed. At the age of 91 the patient developed osteomyelitis. Antibiotic therapies were initiated. Current Clinical Approach: In addition to antibiotic therapy the patient agreed to have a continuous supply of oxygen delivered transdermally to the wound at a rate of 3 ml/hour from a device that derived pure oxygen from atmospheric air (EpiFLO SD ) as the patient ambulated. 24/7 oxygen therapy was used in conjunction with a fully occlusive Johnson & Johnson 3″ × 4″ island dressing. Patient Outcomes: After 3 weeks of continuous oxygen and antibiotic therapies the patient was able to ambulate without pain. The planned amputation was canceled. The wound bed was characterized by new granulation tissue and reepithelialization. The antibiotic treatment was discontinued after 30 days, but the tiny, 2 ounce oxygen therapy device was continued until full wound closure 11 weeks later. The wound remained closed for 36 months, the remainder of the patient’s life. Conclusions: The effectiveness of the antibiotics in this patient as well as other oxygen‐sensitive wound healing processes may have been potentiated and enhanced by the continuous availability of oxygen at this dosage. Further carefully controlled studies of transdermal sustained oxygen delivery for the treatment of chronic wounds with osteomyelitis are needed to clarify the underlying scientific mechanisms of this beneficial effect. The support of Ogenix Corporation in supplying EpiFLO SD for this project is appreciated.