Topical Oxygen Therapy: Another Look at the Evidence

Matthew Regulski, DPM:

This in diabetes care has one of the highest recommendations on Cochrane, about the study design and its power, and its non-biased that it had shown in that study. Again, what I liked about doing the topical oxygen is they set this up, did all the clinical studies first. This one in diabetes care is a multinational clinical trial. Multiple countries were involved in that, but the kind of undertaking that requires and the expense that it requires, RCTs are very, very expensive to do. But they took the time because they cared about putting forth the science and showing the proof and the evidence of what we think oxygen can do, and does it actually carry through to showing significant healing rates and reductions in complications, hospitalizations, amputations. And I think all of these papers that we have, that people should read for themselves, should glean what they do from that, to show the great evidence, to prove that oxygen cares.

And utilizing this in the safety of your own home, so people are safe and they're relaxed and the compliance factor goes through the roof, when they can do this. Every chronic wound is going to be hypoxic. Every chronic wound needs oxygen into the wound. That's why we do a lot of the things that we put in there to take off, to remove, help to increase flow of blood, flow of oxygen into the wound, bringing cells to the area, in order to produce a healed wound. Multifactorial problem, needs a multi-modal therapy. You have to prepare that guy to repair and thus the need to do all of these things. But oxygen is critical. It affects every phase of the wound healing cycle. Every phase of the wound healing cycle is perturbed by the deficiency in oxygen. Anything that we can do, if it proves itself to be of value and that it can do what it says it does, through this high level of evidence, I hope everybody in the future will avail themselves.

Because I try to get every one of my chronic wound patients, if they meet that criteria, to be able to get into utilizing topical oxygen. And again, doing good standard of care in conjunction with utilizing that. But I think this is pointing to that germane factor of how oxygen actually affects all phases of the wound healing cycle. I know I'm being repetitive when I'm saying that, but people forget about that. They forget about this simple element, which is the third most abundant element in the universe, by the way, is that it's necessary for and affects all phases of the wound healing process. Cells that we need to make collagen, cells that we need to make blood vessels, cells that we need to utilize to destroy pathogens in the wound, all require high levels of oxygen. The collagen that we put forth in there to produce a healed wound and maintain tensile strength, requires significant cross-linking and tightening of those collagen, requires oxygen level.

Blood vessel growth. That blood vessel requires significant collagen in order to form a tube in which blood flow can move through, otherwise it becomes leaky and it's no good, and blood leaks out of it. That requires significant amount of collagen, but also cells in order to sprout forth and make new blood vessels, require high amounts of oxygen to function at it's maximal event.

You can see the multitude, and we go back to saying this, that there's multitude of RCTs with high level of evidence that prove that this device can do what it says it do. Yes, we know oxygen affects all phases of the wound healing cascade, but can it actually, by raising the pressure of it, can it prove itself to be effective? And I think with all of these studies that we have shown, that it can actually do that through RCT data, showing that it can actually accelerate healing, prevent hospitalization, and lower your risk for amputation and lower your risk for recurrence.