Topical Oxygen Therapy: The Latest Evidence and Insights

Matthew Regulski, DPM:

I am Dr. Matthew Regulski. I'm the Medical Director of the Wound Institute of Ocean County, New Jersey, here in Toms River, New Jersey, and I'm partner of Ocean County Foot and Ankle Surgical Associates in Toms River, New Jersey. I've been in practice now for 18 years, treating mostly doing wound healing, chronic wound, diabetic reconstructive surgery, and limb salvage. But what's great about the topical oxygen is that they did the work beforehand. They did the heavy study, they did the RCT, they did real world application, to be able to show that it can actually do what it says that it can do and come out in these reportable outcomes, showing proof that it actually can do those things and that, particularly in the International Wound Journal, showing that these outcomes are reducing hospitalization, reducing amputation, and reducing recurrence is another big thing.

Because 50% of diabetics will have a recurrence of their foot ulcer within a year. But again, that goes back to the sustainability of putting oxygen, how it affects the wound healing process, because oxygen cares, collagen synthesis, angiogenesis resistance infection, epithelialization, sustainability, that points to that. But again, this is seven RCTs and looking at hundreds and hundreds of patients, showing the healing outcomes and showing the sustainability.

I think, when we look at real world data, like these we're showing, some of the faults that people give to RCTs is that these are people that are medically optimized, and that's not what we're seeing every day in the clinic. And that's true. I'm seeing more people in the office in the wound centers are on hemodialysis, who have more exposed bone and tendon problems, more deeper wounds than that you would see in an RCT. Usually, in RCT, wounds are just into the SubQ, no exposed bone or tendon. They have optimized hemoglobin A1Cs, and we're seeing a lot of people, and the average now is coming 10 and over. People with good blood flow in an RCT, but in the real world, we're seeing these people who have significant vascular disease, both arterial and venous.
So when you look at real world data, bring these people in, match these individuals up, bring them in that you see every day, and when you can see some of these great outcomes, 88% reduction in hospitalizations utilizing topical oxygen, 71% reduction in amputation rate, I think, is amazing, because a diabetic foot ulcer has a 50% mortality rate. Every 1.2 seconds, in this country, there is a diabetic foot ulceration, 33 million diabetics that we have, 95 million pre-diabetics going on. It's only getting worse out there. And when you have that diabetic foot ulcer, you're two and a half times more likely to be hospitalized, and one and a half times more likely to die during that foot ulcer episode.