RESUMO
Recent advances in topical hyperbaric oxygen technology identified the use of low-pressure topical hyperbaric oxygen therapy in enhancing wound healing. This study prospectively examined the feasibility of technology transfer from university to Health Maintenance Organization personnel, using topical hyperbaric oxygen therapy to heal necrotic wounds. Fifteen patients with 24 gangrenous and/or necrotic wounds that did not improve or worsened after at least 6 weeks of standard wound care were treated with topical hyperbaric oxygen therapy by trained HMO personnel. Four patients underwent digital amputation for osteomyelitis and/or gangrene followed by topical hyperbaric oxygen therapy. Assessment parameters included wound healing and cost of wound care before and after topical hyperbaric oxygen therapy. Six of the six Level 2 wounds healed within 2 to 4 weeks, nine of the ten Level 3 wounds healed within 4 to 10 weeks, and seven of the eight Level 4 wounds healed within 4 to 12 weeks. The ulcers improved by a mean of 0.829 cm2 per day. T test (SSPS 7.5) showed significant improvement per day after topical hyperbaric oxygen therapy, t = 5.217, df = 24, P < 0.0001 (95% CI = 1.13-0.49). Wound healing with topical hyperbaric oxygen therapy was associated with decreased costs. The results of this support the feasibility of transfer of new wound healing technology from research to HMO personnel.
Assuntos
Oxigenoterapia Hiperbárica/métodos , Cicatrização , Ferimentos e Lesões/terapia , Idoso , Idoso de 80 Anos ou mais , Análise Custo-Benefício , Estudos de Viabilidade , Feminino , Sistemas Pré-Pagos de Saúde , Humanos , Oxigenoterapia Hiperbárica/economia , Masculino , Pessoa de Meia-Idade , Necrose , Projetos Piloto , Estudos Prospectivos , Transferência de Tecnologia , Resultado do Tratamento , Universidades , Ferimentos e Lesões/patologia , Ferimentos e Lesões/fisiopatologiaRESUMO
The clinical case presented in this article demonstrates the necessity of prompt treatment of suspicious mass lesions and highlights the importance of always sending tissue specimens for proper evaluation. In this case, the prognosis was directly related to extent of the disease. Delaying treatment or improper treatment could easily mean the difference between life and death. When a highly aggressive rhabdomyosarcoma is encountered, a planned formal excision with adequate margins is mandatory to achieve optimal results. Multidisciplinary care, including oncology, radiology, pathology, and podiatry services, is preferred. A current 4-year follow-up of the patient discussed in this article has demonstrated no recurrence.