Hyperbaric and Topical Wound Oxygen: A Comparative Study

Francis Derk, DPM • STVHCS: Chief Podiatry Services• UTHSC: Assistant Clinical Professor

Two similar cases of Partial First Ray Amputations secondary to Osteomyelitis and soft tissue infection were compared. Negative pressure was used in both cases set at 125 mm of HG for approximately 3 weeks, changed 3 times weekly, and started day 1 in conjunction with HB02 or TW02 modalities. Topical wound care and off loading consisted of wet to dry dressings and Cam boots respectively. The TW02 patient lived over 65 miles from the nearest HB02 facility and could not afford the costs of transportation. Safety: Both wounds were debrided, titrated to antibiotics per the C&S, and normal WBCs were attained prior to initiation of therapies as listed below.

Results:

• The TWO2 wound took 17 days longer to heal
• TWO2 costs were less expensive
• TWO2 was utilized to full closure vs HBO2 whichwas limited to 40 dives (day 56 and not fully healed)
• The HBO2 wound apart from 40 dives required 32 additional days of conventional wound healing to closure
• No baro-trauma or complications were incurred