(CS-096) Cyclical Pressurized Topical Oxygen Therapy for the Treatment of Complex Wounds and Limb Preservation

Chronic wounds are characteristically hypoxic, with PO2 in the center of the wound below what is needed to support tissue repair. Cyclical Pressurized Topical Oxygen Therapy (CPTOT)  delivers 02 deep into the wound bed, raising tissue PO2 5-fold and sustaining it over time. Increased wound tissue P02 levels provide for the inflammatory mediators, immune response, ROS and growth factors necessary for wounds, stalled in the inflammatory phase of healing, to progress, and promote the angiogenesis, fibroblastic activity and keratinocyte migration necessary for a healthy robust proliferative phase of healing.


Methods:

CPTOT delivers high concentration oxygen in a boot-like extremity chamber, at pressures that cycle between 7.5 and 37.5 mmHg. Cyclical pressure increases the partial pressure of O2, allowing a greater amount to diffuse into the to the wound bed. It also mobilizes blood and lymphatic fluids, reducing edema and further enhancing 02 diffusion and neovascularization within the wound bed and encouraging granulation from the base. CPTOT is applied by the patient at home, over existing gas permeable dressings.

Results:

Case 1 involved a 52-year-old female with left foot full-thickness burn wounds, present for 5 months. The wound resolved at 15 weeks, after only 4 weeks of TWO2 therapy.

Case 2 involved a 52-year-old female, s/p revascularization and a failed  left 1st ray resection. The surgical site remained non-healing at 8 months and was complicated by chronic lymphedema. The wound resolved at 16 weeks, after 10 weeks of TWO2 therapy.

Case 3 involved a 64-year-old male with pyoderma gangrenosum resulting in limb threatening circumferential full tissue loss wounds of bilateral lower legs with exposed muscle and tendon, present for 10 months. After initiation of TWO2 the patient quickly mounted robust granulation tissue, allowing graft application.

Discussion:

TWO2 provided rapid, durable wound healing in 3 complex wound cases.  Wounds were able to progress out of the inflammatory phase to a robust proliferative phase of healing, resulting in more durable closed tissue, less likely to allow wound reoccurrence.  Advances in wound care are bringing forth exciting new adjunctive evidence-based therapies that continue to redefine the standard of care in wound treatment. CPTOT is one such adjunctive therapy.