Continuous Topical Oxygen Therapy as Part of the Reconstructive Ladder of Limb Salvation: a Case Series

Introduction

The term surgical wound dehiscence (SWD) has been defined as ‘separation of the margins of a closed surgical incision that has been made in skin, with or without exposure or protrusion of underlying tissue, organs, or implants.’ This is most likely to occur within 5 to 8 days post-op.

The goal for managing SWD is to expedite wound closure. There is not one singular “gold standard” therapy, though continuous topical oxygen therapy (cTOT) has been proven to promote tissue healing in wounds of all etiologies.

Results

• The mean number of days from starting cTOT to the SWD healing was 52.6 days
• Additional surgical intervention or hospitalization for SWD was not required after treatment

Discussion

• Surgical intervention in the lower extremity can lead to complications that can negatively impact the post-operative course for the patient, as well as contribute to patient comorbidity and mortality.
• Oxygen plays an important role in wound immune response, supporting immune cell activity, cell migration, and bacterial killing via the reactive oxygen species.
• Given cTOT’s mechanism of action, the authors believe that reestablishment of adequate blood and oxygen to the tissues, combined with the immunogenic properties of oxygen, supported the rapid wound closure observed in these patients.

Authors:

Edward Kormylo, DPM; Windy Cole, DPM, CWSP; Jacob Wielgomas, MSII