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Case Series/Study
Chronic wounds, including diabetic foot ulcers (DFUs), venous leg ulcers (VLUs), and arterial wounds, pose significant challenges to healing, particularly for patients in remote or rural areas. Inadequate tissue perfusion is a key factor in most chronic wounds, due to disruption of the microvasculature, inflammation, edema, increased metabolic demand, and underlying chronic conditions. While traditional hyperbaric oxygen (HBO) is an established modality for improving wound healing, it is not covered by insurance for most wounds, and its accessibility remains a barrier for patients in remote settings. A unique, portable, multi-modality topical oxygen therapy (TOT) device*, which concurrently delivers both intermittent compression and pressurized topical oxygen therapy, presents a home-based alternative that may address these challenges.
Methods:
This case series examines four patients with chronic wounds, who were treated with multi-modality TOT in rural California. Patients received multi-modality TOT in their homes, and outcomes such as wound healing progression, treatment compliance, and overall limb salvage were assessed.
Results:
Four multi-morbid patients with 5 wounds (2 DFU, 1 mixed arterial/venous/DFU, and 2 DFU s/p amputation due to osteomyelitis) were treated with multi-modality TOT. Four wounds healed completely, and one wound achieved 95% closure in an average of 3 months.
Age | Sex | Start Date | End Date | Time on Therapy (months) | Wound Location | Wound Type | Measure Date | Length | Width | Depth | Area | Volume |
72 | M | 11/19/2024 | 12/6/2024 | 0.6 | Left 1st Toe | Amputation | 11/19/2024 | 3 | 0.8 | 0.1 | 3 | 0.3 |
12/6/2024 | 0 | 0 | 0 | 0 | 0 | |||||||
73 | M | 1/20/2024 | 4/7/2024 | 2.6 | Left 1st Toe | Amputation | 2/23/2024 | 2 | 0.2 | 0.1 | 0.4 | 0.04 |
3/8/2024 | 0 | 0 | 0 | 0 | 0 | |||||||
59 | M | 2/19/2023 | 6/16/2023 | 3.9 | Right 1st Toe | Multi-morbid | 2/3/2023 | 1.5 | 1.1 | 0.2 | 1.65 | 0.33 |
6/16/2023 | 0.4 | 0.4 | 0.1 | 0.16 | 0.016 | |||||||
53 | F | 3/9/2023 | 7/3/2023 | 3.9 | Right Heel | Diabetic Ulceration | 2/23/2023 | 2 | 0.5 | 0.6 | 1 | 0.6 |
7/3/2023 | 0 | 0 | 0 | 0 | 0 | |||||||
3/9/2023 | 7/3/2023 | 3.9 | Right 1st Toe | Diabetic Ulceration | 2/23/2023 | 1.1 | 1.2 | 0.5 | 1.32 | 0.66 | ||
7/3/2023 | 0 | 0 | 0 | 0 | 0 |
Discussion: Multi-modality TOT enabled improved access to oxygen therapy for patients in remote areas. All patients experienced accelerated wound healing, with reduced time to closure and improved quality of healed scars. Multi-modality TOT demonstrated effectiveness in managing difficult chronic wounds and provided additional benefits such as mitigating chronic lymphedema and resolving postoperative surgical site dehiscence. The portability and home-based application of multi-modality TOT enhanced patient compliance, contributing to positive outcomes.