Author: Jebril W, Nowak M, Palin L, Nordgren M, Bachar-Wikstrom E, Wikstrom JD.

Keywords: analgesia, diabetes, dressing, HBOT, hard-to-heal leg ulcer, hyperbaric oxygen therapy, pain, topical continuous oxygen therapy, topical oxygen therapy, TCOT, TOT, ulcer, venous ulcer, wound, wound healing

Abstract: Managing painful hard-to-heal leg ulcers is challenging with current therapeutic options. Wounds are prone to being hypoxic, and the subsequent pain is often related to hypoxia. Hyperbaric oxygen therapy (HBOT) is used to treat hard-to-heal leg wounds by delivering 100% oxygen at a pressure 2–3 times higher than atmospheric pressure. Unfortunately, most patients cannot be offered HBOT because it is costly and needs to be applied at specialised centres. Therefore, topical continuous oxygen therapy (TCOT) is a novel alternative for continuous local oxygen delivery to wounds and is associated with improved wound healing; however, its effect on painful wounds is unknown. This retrospective study was conducted on 20 patients, of whom 17 had painful hard-to-heal leg ulcers. In 13 patients (76%) with painful ulcers, TCOT was associated with rapid and substantial pain alleviation. Also, eight (40%) of the patients’ wounds healed entirely with TCOT. This study suggests that TCOT may represent a novel pain management device for hard-to-heal wounds.