RESUMO
OBJECTIVE: To identify potential factors, including cigarette smoking and diabetes status, that affect wound-healing outcomes during a six-week course of hyperbaric oxygen therapy (HBOT). METHOD: Seventy-three patients with 85 non-healing lower extremity wounds were treated with hyperbaric oxygen therapy (100% oxygen, 2.4 atmosphere absolute, (ATA), for 90 minutes). The wound area was evaluated over the six-week treatment period. RESULTS: A non-hierarchical clustering analysis of normalised wound-area data revealed that healing responses could be segregated into three groups: robust healing (n=31, over 50% reduction in area), minimal healing (n=33, 15% reduction) and non-healing (n=21,60% increase in area). Further analysis revealed that cigarette smoking was associated with poor response (p<0.0001), whereas diabetes was not. Robust responders had higher blood levels of creatinine and urea nitrogen, increased peripheral oxygenation (TcpO2), and were younger than less responsive patients. CONCLUSION: The results suggest that response to HBOT is variable and some patients do not benefit from it. Clinicians should evaluate available laboratory values, age and social history to determine if a patient is likely to benefit from HBOT.
