Kwee E, Borgdorff M, Schepers T, Halm JA, Winters HAH, Weenink RP, Ridderikhof ML, Giannakópoulos GF, et al.
European journal of trauma and emergency surgery : official publication of the European Trauma .... Date of publication 2024 Feb 22;volume ():.
1. Eur J Trauma Emerg Surg. 2024 Feb 22. doi: 10.1007/s00068-023-02426-2. Online
ahead of print.
Adjunctive hyperbaric oxygen therapy in the management of severe lower limb soft
tissue injuries: a systematic review.
Kwee E(1), Borgdorff M(2), Schepers T(1), Halm JA(1), Winters HAH(2), Weenink
RP(3)(4), Ridderikhof ML(3)(5), Giannakópoulos GF(6).
Author information:
(1)Trauma Unit, Department of Surgery, Amsterdam UMC (Location AMC), J1A-214
Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
(2)Department of Plastic, Reconstructive Surgery and Handsurgery, Amsterdam UMC,
Amsterdam, The Netherlands.
(3)Department of Hyperbaric Medicine, Amsterdam UMC, Amsterdam, The Netherlands.
(4)Department of Anesthesiology, Amsterdam UMC, Amsterdam, The Netherlands.
(5)Department of Emergency Medicine, Amsterdam UMC, Amsterdam, The Netherlands.
(6)Trauma Unit, Department of Surgery, Amsterdam UMC (Location AMC), J1A-214
Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
g.giannakopoulos@amsterdamumc.nl.
PURPOSE: Traumatic crush injuries of the lower limb often accompany severe
complications. The incorporation of hyperbaric oxygen therapy to standard trauma
care may have the potential to diminish injury-related complications and improve
outcome in such cases. This systematic review aims to evaluate the effectiveness
of hyperbaric oxygen therapy in the management of severe lower limb soft tissue
injuries.
METHODS: The electronic databases Medline, Embase and Cochrane Library were
searched to identify studies involving patients with crush-associated sever
lower limb soft tissue injuries who received hyperbaric oxygen therapy in
conjunction with standard trauma care. Relevant data on type of injury,
hyperbaric oxygen therapy protocol and outcome related to wound healing were
extracted.
RESULTS: In total seven studies met the inclusion criteria, involving 229
patients. The studies included two randomized clinical trials, one retrospective
cohort study, three case series and one case report. The randomized
placebo-controlled clinical trial showed a significant increase in wound healing
and decrease in the need for additional surgical interventions in the patient
group receiving hyperbaric oxygen therapy when compared to those undergoing sham
therapy. The randomized non-placebo-controlled clinical trial revealed that
early hyperbaric oxygen therapy reduces tissue necrosis and the likelihood of
long-term complications. The retrospective cohort study indicated that
hyperbaric oxygen therapy effectively reduces infection rates and the need for
additional surgical interventions. The case series and case report presented
beneficial results with regard to wound healing when hyperbaric oxygen therapy
was added to the treatment regimen.
CONCLUSION: Hyperbaric oxygen therapy is generally considered a safe therapeutic
intervention and seems to have a beneficial effect on wound healing in severe
lower limb soft tissue injuries when implemented as an addition to standard
trauma care.
© 2024. The Author(s).
DOI: 10.1007/s00068-023-02426-2
PMID: 38386077
