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Hyperbaric oxygen therapy in the management of nonhealing wounds in patients with critical limb ischemia

Gunalp Uzun, Senol Yildiz and Samil Aktas

Critical limb ischemia is characterized with intolerable pain at rest and nonhealing wounds and/or gangrene. The treatment of nonhealing wounds in patients with critical limb ischemia calls for an extraordinary effort. However, major amputation is required in a significant number of patients. Hyperbaric oxygen therapy is one of the adjunctive treatments used in nonhealing wounds. Hyperbaric oxygen therapy enhances collagen synthesis and maturation, fibroblast proliferation, epithelialization, increases leukocyte bacterial-killing capacity and induces angiogenesis. Hyperbaric oxygen therapy also exerts an antibacterial effect on selected microorganisms and reduces wound infection. Hyperbaric oxygen therapy is not a miraculous treatment modality. It is a good adjunctive therapy that increases the healing rate of wounds in selected patients. Hyperbaric oxygen therapy should be instituted together with conventional treatments. Antibiotherapy, strict metabolic control, daily wound care and debridement should not be overlooked during hyperbaric oxygen therapy