Use of Continuous Topical Oxygen Therapy in Combination to Optimize the Chronic Wound Environment Prior to Cellular, Acellular, and Matrix-Like Product Application: A Retrospective Case Series

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Abstract:

Background. This retrospective case series details the use of a continuous topical oxygen therapy (cTOT) device for wound bed preparation prior to the application of cellular, acellular, and matrix-like products (CAMPs) on lower extremity wounds.

Methods. A retrospective records review was conducted in a single outpatient wound care center. Treatment consisted of 2 weeks of cTOT followed by CAMP application. Weekly wound photos and measurements were obtained through chart review. Patients included in this study did not achieve complete wound closure within the 2-week cTOT treatment period and therefore were transitioned to CAMP application as per standard practice at the lead author’s clinic.

Results. This study included 4 patients (5 wounds). The mean patient age was 71.8 years, and wound types included 3 diabetic foot ulcers (DFUs) and 2 venous leg ulcers (VLUs). The mean wound area reduction in this patient cohort was 74.7% and 76.1% at 4 and 6 weeks, respectively. Overall, a mean healing time of 8 weeks was noted across all wounds with a mean number of 6 CAMP applications.

Conclusions. Wound healing should be approached in an algorithmic manner, starting with wound bed optimization. In this patient cohort, cTOT proved to be an effective way to improve the quality of the wound bed, in addition to standard cleansing and debridement before CAMP application. The authors believe that this combination of topical methods might have synergistic effects to improve wound healing, and the results of this study support this assumption.

Conclusion:

This small feasibility study is a step toward transforming wound care into a precision practice. Wound healing should be approached in a systematic and algorithmic way, starting with wound bed optimization. With looming limitations in the number of CAMP applications permitted under various LCD/Local Coverage Article policies, as well as the constraints in accessing certain CAMPs, finding innovative methods to improve wound healing will have great value across all clinical settings.

Authors:

Naz Wahab, MD ; Windy Cole, DPM ; Emma Woodmansey, PhD