The importance of adequate levels of oxygen during the healing process is universally acknowledged.
For a wound to heal, it must have sufficient energy and nutrients to drive the healing process. Oxygen has a key role in:
1. metabolic support (cell respiration and energy generation)
2. matrix repair (the structures of new skin)
3. infection control (inhibits growth of certain bacteria)
4. stimulation and control of cell responses
Even at the most basic level, it is self evident that oxygen is needed to release the energy needed for the whole repair and recovery process, through respiration. Energy metabolism in the absence of oxygen is inefficient and leads to an unhelpful metabolic acidosis in the tissue.
Wounds that receive adequate oxygen generally heal at an increased rate compared to those that don’t have an adequate oxygenation.
So why is sufficient oxygen not being supplied by the blood vessels? It has been hypothesised that in cases of venous hypertension a ‘fibrin cuff’ can develop around the blood vessels which prevents the passage of oxygen and other nutrients across the capillary wall to reach the healing tissues where they are needed for energy generation.
Ischemia (a low oxygen state usually due to inadequate blood flow leading to hypoxia in the tissue) is also a global enemy of healing. Modern growth factor therapies cannot accelerate repair processes that are lacking oxygen
(Robson 1998).
Hypoxemia, caused by disrupted vasculature, is a key factor that limits wound healing. Correcting hypoxemia through the administration of supplemental oxygen (O2) can have significant beneficial impact on wound healing in the perioperative and outpatient settings. (Gordillo 2003).
Robson MC, Mustoe TA, Hunt TK, “The future of recombinant growth factors in wound healing” J. Surg., 1998; 176(suppl 2a): 805-825.
Gordillo GM, Sen CK, “Revisiting the essential role of oxygen in wound healing”
Am. J. Surg. 2003; 186(3): 259-263.
