1. Moderate to Major Thermal Burn Patients Could Benefit from Hyperbaric Oxygen Therapy in Wound Healing
Cen-Hung Lin, Yu-Hao Huang, Su-Fei Ou, I-Feng Sun,
Cheng-Sheng Lai, Sin-Daw Lin, Su-Shin Lee
Division of Plastic Surgery, Department of Surgery,
Kaohsiung Medical University Hospital
2015 ASPS / 17th – 20th, October / Boston
Nothing to disclose.

2. Introduction
Hyperbaric oxygen therapy (HBOT) has been known for its benefit in wound healing from animal trials and clinical studies.

3. Introduction
various benefits in clinical studies of HBOT for thermal burn
A retrospective study to evaluate the effect of HBOT in wound healing

4. Patients and Methods
74 patients admitted to KMUH burn center (March 2007 to March 2014)
- second to third degree thermal burn
- 15 ~ 40 % TBSA
- ≥ 18 years old
 36 with detailed medical records

5. Patients and Methods
1) HBOT group – received HBOT while in burn center + standard burn care : 18 patients 2) non-HBOT group – merely standard burn care : 18 patients

6. Patients and Methods
8 separate regions in 27 patients (14 in HBOT and 13 in non-HBOT group with detailed TBSA records) - 70 and 70 wound area reduction rates per region obtained in these 2 groups respectively

7. Results : Patient Characteristics
Group 1
(without HBOT)
Group 2
(with HBOT)
P value
Number 18 -
Sexuality
(number)
Male 13
Female 5
Age (yr) (mean)
42.67 ± 2.57
45.17 ± 4.19
0.556
TBSA (%) (mean)
21.17 ± 1.47
22.61 ± 1.52
< 0.01
- paired t test
- HBOT group had significantly larger TBSA than non-HBOT group

8. Results : Hospitalization
Group 1
(without HBOT)
Group 2
(with HBOT)
P value
Hospital Stay (day) (mean)
24.39 ± 2.75
31.89 ± 2.96
0.056
Hospitalization
Group 1
(without HBOT)
Group 2
(with HBOT)
P value
Burn Center
Stay (day) (mean)
16.56 ± 1.73
20.56 ± 1.93
0.111
paired t test
longer in HBOT group but not significantly

9. Results : Debridement Times
Operation
Group 1
(without HBOT)
Group 2
(with HBOT)
P value
Debridement Times
(mean)
0.67 ± 0.20
0.94 ± 0.25
0.399
paired t test
more debridements in HBOT group but not significantly

10. Results : Wound Healing Rate
Operation
Group 1
(without HBOT)
Group 2
(with HBOT)
P value
TBSA reduction rate
(%/day) (mean)
0.20 ± 0.16
0.25 ± 0.20
0.035
independent T test
70 and 70 regions in each group
faster wound healing rate in HBOT group

11. Discussion various results in clinical studies
studies comparing wound healing rate were few
only one AHA level I study revealed shorter wound healing time (Hart 1974)

12. Discussion : Our Study stay or burn center stay
1) no significantly difference in hospital
stay or burn center stay
2) significant faster wound healing rate
in HBOT group
3) larger TBSA in HBOT group

13. Discussion : our study
Patients and their family members usually asked for longer hospitalization once they initiated HBOT.
 might also be the reason why there is no significantly shorter hospital stay in HBOT group

14. Discussion : Our Limitation
1) selection bias : available medical records 2) non-randomized study 3) diverse HBOT sessions 4) burn degree distributions were varying 5) excluded children in our study (< 18 years) 6) no complete life-supporting device in chamber  unstable patients couldn’t undergo HBOT

15. Conclusion
hyperbaric oxygen therapy could enhance wound healing in moderate to major thermal burn patients
awaiting further randomized study