June 13, 2022
Burns generate around 80.000 deaths per year and cause severe lesions in the skin and other tissues, compromising the physical and psychological health of the patient. We can distinguish five types of burn-causing agents. On one hand, we have the most frequent ones caused by heat and electricity and, on the other hand, those that involve chemicals and radiation. Also, we can subclassify them according to the depth of the lesion, in other words, the extent of the injury. Considering the gravity of burns, and the high rate of mortality associated, once the patient arrives at the medical institution, they seek to preserve his life because there is a great loss of water. Therefore, the priority is to achieve wound healing as quickly as possible, otherwise, the clinical condition of the patient could rapidly get worse and generate serious complications. Prolongation of the inflammatory phase can delay the healing, promote an ideal scenario for bacterial proliferation, and lead to inadequate healing, extending the damage to unaffected areas. The usual treatment can reduce, but not prevent, infections and promote wound drying by using topical agents and dressings.
When the soft tissues, such as skin and muscles, are affected by burns, the blood flow in the damaged area reduces considerably, producing inflammation. The incorporation of hyperbaric oxygen treatment (HBOT) can produce a synergic action with the conventional treatment used on burns because among its main beneficial effects are the reduction of inflammation, pain, and healing times thanks to the re-oxygenation of tissues. On the other hand, it is capable of treating and preventing infections. In this type of complex clinical condition, it is essential to avoid instances that complicate and compromise the patient's health.
In cases where graft colocation is necessary, hyperbaric treatment is essential to obtain a successful implantation and a better oxygen supply to the affected area. Health professionals not only indicate HBOT for the post-surgical phase, but also as surgical preconditioning to generate an increase in antioxidant defenses, which are key to preventing cell damage, and thus increasing graft survival.
A trial made by Cianci and cols. demonstrated that the significant reduction of hospitalization time in burned patients was obtained thanks to the indication of hyperbaric chamber during the first days. In addition, it was reported a decrease in the necessity of surgery and in recovery time, in comparison with patients who received conventional care.
In conclusion, incorporating HBOT in treating patients with different types of burns contributes to the increment of cicatrization and a better quality of tissues in tissue regeneration and wound healing.