| 202 |
Case Study
|
Transdermal sustained oxygen therapy (TSOT) heals chronic diabetic ulcers after other advanced therapies failed: a retrospective review of 13 cases Adir Ludin, MD, Claire Wilson, RN, BSN, ET, CWON, DAPWCA Introduction. Chronic Diabetic Ulcers (CDUs) cause discomfort, pain and reduction in quality of life (QOL). They are a harbinger for partial lower limb amputations. CDUs are estimated to affect approximately 15% of all diabetic individuals during their lifetime Rationale. Oxygen is essential in wound healing, as a factor for oxidative metabolism and as an important cell signal interacting with growth factors. The only existing methods of delivery of oxygen to wounds are intermittent, including hyperbaric oxygen chambers and topical applications. We describe a novel concept of sustained oxygen delivery, 24/7, at normobaric pressure. . .Materials. We used an innovative, disposable, device that produces pure oxygen at a rate of 3 cc/hr, for 7 days. The device weighs 2 ounces and measures 2x1x1.5 inches. The oxygen is delivered via a 5 Fr. cannula to the wound, covered by an occlusive dressing. It is FDA cleared for a broad list of indications Methods. We describe the outcome of 13 patients with lower extremity CDUs that failed multiple prior advanced wound healing therapies. Mean age of wounds was 17.5 months (range 4-36 months). Results. The wounds were healed with a mean time to closure of 7.5 weeks (range 2-23 weeks). Pain resolved within the first 2 weeks in most cases. No reported complications Conclusion. TSOT represents a new approach to the care of CDUs. It is a unique method of delivering oxygen continuously to the wound, as the patient ambulates. It enhances healing and promotes tissue regeneration. Healing of CDUs has significance to the diabetic population, by eliminating pain, improving QOL and eliminating the need for amputations. The impact on health care cost is significant. Large, prospective trials are needed to document clinical outcomes of TSOT. |
|