Treatment of a Chronic Stage IV Pressure Ulcer using Topical Wound Oxygen (TW02) Therapy
Anku, Comfort RN, Dr. Christian Frye2 1 Post Inn Village, Toronto, Canada, 2 AOTI Ltd, Galway, Ireland
Introduction
Chronic wounds are frequent, difficult to treat and show high rates of complications. We examined the clinical efficacy of a unique pressurized topical oxygen therapy (TWO2) device in a long term care setting in Canada on a 67 y/o male patient with a stage IV pressure ulcer.
Method
The patient was treated daily with TWO2 therapy for 90 minutes. Prior to each treatment, the patients wound dressings were removed and the wound bed was irrigated with a normal saline solution. After each TWO2 treatment, the wound was treated with Silversorb and Betadine then redressed with standard gauze dressing. The TWO2 device delivered humidified medical grade oxygen at a constant pressure of 30 mbar.The wound care coordinator performed weekly wound assessments including photos to document the wound area, volume and changes in each from the previous assessment.
Results
Initial wound measurements indicated the ulcer had an area of 31.2 cm2 with a volume of 109.2 cm3. Tissue was noted to be very necrotic and the peri-wound was macerated. After one week of treatment, the wound area and volume had increased slightly, however the physician noted that the maceration had improved. Week 2 measurements showed a decrease in both area and volume with significant granulation. By week 3, the wound was 95% covered with granulation and it was noted the peri-wound was less friable. Wound area had decreased by 43% and the volume by 41% and dressings were now being done with Dermagen packing. The patient was hospitalized after 6 weeks of therapy for an unrelated condition. At that time, his wound area had decreased to 4.55 cm2 and volume to 11.38 cm3.TWO2 therapy was discontinued during the hospitalization. TWO2 resumed one month later; with an area of 5.28 cm2 and volume of 12.5 cm3. After 2 additional weeks of therapy, the wound had 100% closure.
Observations:
- TWO2 improves local tissue perfusion
- TWO2 softens necrotic tissue and enhances debridement
- TWO2 eliminates maceration
- TWO2 reduces nursing intervention time
Conclusion
Patients with severe chronic wounds benefit from the treatment with TWO2 and show remarkable wound closure rates.
Presented at EWMA 201O May 26-28, Geneva Switzerland