How does Oxygen Wound Therapy (OWT) work?
- The basic premise of Oxygen Wound Therapy is that a healing wound demands greater than normal oxygen levels to allow many parts of a complex repair system to function properly. If oxygen demand outstrips supply, then the wound goes into a dormant state. We believe that Oxygen Wound Therapy delivers sufficient O2 into the wound bed to allow an increase in TCpO2 in the tissues around the wound, and we are commissioning research into how this occurs.
- There are many ways of delivering oxygen to the wound bed, but most involve the use of some kind of "container" such as a plastic bag or hard plastic box to trap oxygen around the leg or sacral areas and allow O2 concentrations to build up. While these devices have their merits, they really limit patient mobility and comfort.
- Natrox™ intrudes very little, if at all, with any aspect of the patients normal activities, yet deliver sufficient quantities of humidified oxygen to the wound bed to allow key healing processes to restart.
Is Oxygen Wound Therapy safe?
- Natrox™ and IODP are CE marked and have been risk assessed before being release for use in the general population.
- We use low flow humidified oxygen, so the chances of desiccating a wound are absolutely minimal.
- We recommend OWT is only used on prescription from an experienced clinician.
- Oxygen in high concentrations can become an increased fire hazard, but as NATROX™ produces such a small flow and does not store oxygen there is any risk of this becoming an issue for concern to the patient or clinician.
How does OWT compare with Hyperbaric Oxygen Therapy?
Evidence based practice
- Topical Oxygen Therapy (TOT) is now where Hyperbaric Oxygen (HBO) was several years ago, in that it has several centres supporting use, but a large body of grade 1 evidence does not yet exist.
- The main difference between HBO and TOT relates to the effect inspired above atmospheric pressure plays in increasing oxygen dissolved in the blood. The working theory is that it is higher levels of dissolved oxygen diffuse throughout the tissues and assist wound healing. Oxygen Wound Therapy is thought to work by having a pressure gradient of pure oxygen above the wound bed, which in turn leads to increased PaO2 levels in tissues, where oxygen demand has outstripped oxygen supply due to the wound healing requirements being far above basal requirements.
- Inotec AMD recognise, and have commissioned RCT research to try and bridge this gap in our knowledge. What we do have is empirical evidence from several case studies and case series, with results that firmly indicate positive benefits from Natrox™ therapy.
- In recognition of the research required to meet evidence based practice requirements, we are offering Natrox™ as a therapy that should be tried after conventional therapies have failed. We believe that this approach is balanced, and consistent with a first do no harm approach to medicine. We are continuously working with interested Clinicians to build up data on Oxygen Wound Therapy, by collecting wound outcomes on standardised case study report forms. If you would like to assist us in this research, please contact us via our email address.
- In a 10 patient case series undertaken by The Wound Healing Centre, Eastbourne, some very encouraging results were seen on long standing leg ulcer wounds.
User friendliness
- Oxygen Wound Therapy is easy to apply, portable, and relatively low cost compared to other techniques such as HBO or NPWT. As most patients with difficult to heal wounds are community based, it is helpful if they can receive Oxygen Wound Therapy 24hrs per day outside of the acute care facility
- Patients treated with HBO have to keep returning to a facility offering such a service every day for several weeks, and is a major disruption to their lives. Some HBO devices offer whole body oxygenation or limb oxygenation in the patient's homes, but they still require the patient to be immobile for long periods of time.
- The Natrox™ units are small and portable, so can be used to give continuous Oxygen Wound Therapy with little or no interference with normal daily living.
Costs
- We are conscious of the health economics that apply to the introduction of any new therapy in wound healing. Typical treatment costs are below £750 / $1,000 per patient in all but the most recalcitrant cases, and we are often well below that figure.
- Inotec AMD are striving to keep cost barriers to a minimum for any institution seeking to utilise this new technology. To this end, we have several ways for the payor to aquire the use of one or more Natrox units; such as low cost daily rental ( to allow you to try before you buy), a straight purchase, or longer term agreements which allow for enhanced or updated technology from Inotec AMD to be utilised for no extra cost. As each Clinical and Budgetary need is likely to be different, Inotec AMD will work with you to make sure this technology is affordable in appropriate settings.
Please contact us for indicative costs.
Velox Study ReportFebruary 2010
Figure 1: Each colour line represents a patient and demonstrates the healing over a six week period, showing rapid healing in the first three weeks and then slowing.
Figure 2: This clearly shows a large reduction in pain during the first three weeks and then a slower reduction over the following three weeks.