Continuous Topical Oxygen Therapy System Promotes Healing in Chronic Wounds

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Windy Cole, DPM CWSP, shares details from her case series, "Monitoring the Effect of Continuous Topical Oxygen Therapy With Near-Infrared Spectroscopy: A Pilot Case Series in Wound Healing." Read the full paper here.

Transcript:

Windy Cole, DPM CWSP:

Hi, I'm Dr. Wendy Cole. I am the director of wound care research for Kent State University College of Podiatric Medicine, and I'm so happy to be here to introduce you to a new publication.

This is a small pilot study, a 5 patient case series, looking at the effects of topical oxygen therapy in tissues of chronic wounds. So we know that oxygen is very important for almost all of the processes that occur within the wound healing cascade, but unfortunately, because of many reasons, our patients have poor perfusion into the wound tissues. Oftentimes they're older, they have poor protoplasm, they have comorbidities, there can be diffusion constraints because of an amount of tissue loss that's pretty significant or microcirculation or edema. And, because of all of these factors, we often see hard-to-heal wounds have low levels of oxygen within the tissues.

Topical oxygen therapy is a fairly new and innovative treatment for chronic wounds that's getting a lot of buzz in the space. I personally have been part of clinical research in the realm of continuous topical oxygen, and I wanted to see how topical oxygen therapy, continuous topical oxygen therapy, specifically, translated into my clinical population. So I wanted to investigate what was going on in those tissues once continuous topical oxygen therapy was applied, did it support wound healing, and now, with new and innovative imaging technologies, we are able to track oxygen saturation in the tissues. And by applying continuous topical oxygen therapy, did we increase that tissue oxygen saturation? Did it continue to increase? Was it an additive effect over time? And how did that translate into wound healing?

This pilot study was based on the hypothesis of we need to better measure what we manage. And oftentimes, historically speaking, we will try a treatment for a series of a few weeks and see what happens. And if we didn't get the results that we were expecting, then we would switch it up and try a different therapy. But I think, again, with some of these advanced imaging tools or their agnostic devices, such as near-infrared spectroscopy, which we used in this case study, we can track a wound healing, we can make a diagnosis first off ,and say yes these wounds are hypoxic from the get-go, and then apply a treatment like continuous topical oxygen therapy and track the patient's therapy over time to see that we are getting those results at the microscopic and tissue level . And I think again that will help clinicians better measure what we're managing so we can choose treatments that are having the effects that we want and that are indicated for that specific wound and what the deficit is that is causing roadblock for that wound to not enter into a healing trajectory.

I was surprised at how quickly these chronic wounds, again, these were wounds that were stuck, hard to heal, stalled. We all have them floating around in our wound care centers or our offices. We've kind of tried everything under the sun, and they just aren't healing and that's what these patients were for me in my clinical practice. And I was surprised by how quickly many of the wounds went on to complete healing. Again, it was a small pilot study, but 3 of the 5 patients went on to complete healing within the 5-week period of the study. All 5 wounds went on to heal with continuous topical oxygen within 12 weeks, but these really chronic stalled wounds, once we applied continuous topical oxygen therapy and we were able to measure that that had an additive effect over time with increasing tissue oxygen saturation, 3 of the 5 wounds went on to heal within that 5-week period. And that was surprising as to how quickly basically the light switch was turned on and these wounds that entered into a healing trajectory where nothing else had had that kind of result for them.

Well, and as I reiterate, this is a very small pilot study. I'd like to see a larger patient population; I'd love to see a randomized study where we could look at a larger cohort. We could understand also what is the mechanism of action going on here, and I suggest there's probably multiple mechanisms of action. So if we could do some biomarker testing, again, a larger cohort of patients, which is randomized, so we really investigate and flush this out even more, that would be great. But this was a good step in that direction to see, yes, this hypothesis that I had was proven in this small case series. But what could we find out and what information can we glean from larger studies? So I would like to see that happen in the future.