APLIKASI TERAPI OKSIGEN HIPERBARIK DALAM PENYEMBUHAN LUKA KRONIS
DOI:
https://doi.org/10.33820/mdvi.v48i2.161Abstract
ABSTRAK
Luka kronis adalah luka yang membutuhkan waktu lama untuk sembuh, tidak sembuh, atau berulang. Luka kronis sebagian besar terkait dengan hipoksia dan iskemia yang dapat merusak sintesis kolagen dan dapat menyebabkan akumulasi metabolit seperti amonia yang menyebabkan pembengkakan sel dan mengganggu penyembuhan luka. Â Penyembuhan luka melibatkan banyak tipe sel yang berinteraksi, yang terdiri dari beberapa fase, yaitu fase hemostasis atau koagulasi, inflamasi, proliferasi, dan remodeling. Oksigen adalah nutrisi penting untuk luka dan memainkan peran penting dalam setiap tahap proses penyembuhan luka. Terapi oksigen hiperbarik ditujukan untuk mengatasi masalah mendasar dari hipoksia luka dengan menyediakan oksigen ke jaringan iskemik. Terapi oksigen hiperbarik merupakan penggunaan O2 100% pada tekanan lebih besar dari tekanan atmosfir. Pasien menghirup O2 100% secara intermiten sementara tekanan dari ruang perawatan ditingkatkan menjadi lebih dari 1 atmosfer absolut (ATA). Terapi oksigen hiperbarik mengurangi cedera reperfusi iskemia, memobilisasi Stem progenitor cell (SPC) yang telah diidentifikasi berperan dalam vaskulogenesis, meningkatkan aktivitas neutrofil untuk membunuh bakteri, menghasilkan reactive oxygen species (ROS) dan reactive nitrogen species (RNS), dan merangsang berbagai faktor pertumbuhan yang mendukung penyembuhan luka.
Kata Kunci: luka kronis, HBOT, penyembuhan luka kronis, terapi oksigen hiperbarik
Downloads
References
1. Jain KK. HBO Therapy in Wound Healing, Plastic Surgery, and Dermatology. In: Textbook of Hyperbaric Medicine. Springer, Cham; 2017. p. 183–205.
2. Alavi A, Kirsner R. Wound Healing. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ et al., editors. Fitzpatrick’s Dermatology In General Medicine. 9th ed. New York: McGraw-Hill; 2019. p. 16–2700.
3. Andrade SM de, Santos ICRV. Hyperbaric oxygen therapy for wound care. Rev Gaúcha Enferm. 2016;37(2):e59257.
4. Kranke P, Bennett MH, Martyn-St James M, Schnabel A, Debus SE, Weibel S. Hyperbaric oxygen therapy for chronic wounds. Cochrane Database Syst Rev. 2015;2015(6).
5. Bhutani S, Vishwanath G. Hyperbaric oxygen and wound healing. Indian J Plast Surg. 2012;45(2):316–24.
6. Gottrup F, Dissemond J, Baines C, Frykberg R, Jensen PØ, Kot J, et al. Use of Oxygen Therapies in Wound Healing. Acta Univ Agric Silvic Mendelianae Brun. 2015;53(9):1689–99.
7. Fife CE, Eckert KA, Carter MJ. An Update on the Appropriate Role for Hyperbaric Oxygen. Plast Reconstr Surg. 2016 Sep;138(3 Suppl):107S-116S.
8. Thackham JA, McElwain DLS, Long RJ. The use of hyperbaric oxygen therapy to treat chronic wounds: A review. Wound Repair Regen. 2008 May;16(3):321–30.
9. Skeik N, Porten BR, Isaacson E, Seong J, Klosterman DL, Garberich RF, et al. Hyperbaric oxygen treatment outcome for different indications from a single center. Ann Vasc Surg. 2015;29(2):206–14.
10. Chen C-Y, Wu R-W, Hsu M-C, Hsieh C-J, Chou M-C. Adjunctive Hyperbaric Oxygen Therapy for Healing of Chronic Diabetic Foot Ulcers: A Randomized Controlled Trial. J wound, ostomy, Cont Nurs Off Publ Wound, Ostomy Cont Nurses Soc. 2017;44(6):536–45.
11. Jones RE, Foster DS, Longaker MT. Management of Chronic Wounds-2018. JAMA. 2018 Oct 9;320(14):1481–2.
12. Huang E, Heyboer III M, Savaser DJ. Hyperbaric oxygen therapy for the management of chronic wounds: patient selection and perspectives. Chronic Wound Care Manag Res. 2019;6(1):27–37.
13. Francis A, Baynosa RC. Hyperbaric Oxygen Therapy for the Compromised Graft or Flap. Adv Wound Care. 2017;6(1):23–32.
14. Sunkari VG, Lind F, Botusan IR, Kashif A, Liu ZJ, Ylä-Herttuala S, et al. Hyperbaric oxygen therapy activates hypoxia-inducible factor 1 (HIF-1), which contributes to improved wound healing in diabetic mice. Wound Repair Regen. 2015;23(1):98–103.
15. Jeter JP, Wong EB. Hyperbaric oxygen therapy in dermatology. Cutis. 2020;105(1):24–7.
16. Eggleton P, Bishop A, Smerdon G. Safety and efficacy of hyperbaric oxygen therapy in chronic wound management: current evidence. Chronic Wound Care Manag Res. 2015;(April):81.
17. Shah J. Hyperbaric oxygen therapy. J Am Col Certif Wound Spec. 2010;2(1):9–13.
18. Zhang Q, Gould LJ. Hyperbaric oxygen reduces matrix metalloproteinases in ischemic wounds through a redox-dependent mechanism. J Invest Dermatol. 2014;134(1):237–46.
19. Thom SR. Hyperbaric oxygen: Its mechanisms and efficacy. Plast Reconstr Surg. 2011;127(SUPPL. 1 S):1–16.
20. Niinikoski JHA. Clinical Hyperbaric Oxygen Therapy, Wound Perfusion, and Transcutaneous Oximetry. World J Surg. 2004;28(3):307–11.
21. Messages KEY. Hyperbaric oxygen therapy for the treatment of diabetic foot ulcers: A health technology assessment. Ont Health Technol Assess Ser. 2017;17(5):1–142.
22. Hunter S, Langemo DK, Anderson J, Hanson D, Thompson P. Hyperbaric Oxygen Therapy for Chronic Wounds. Adv Skin Wound Care. 2010 Jun 24;23(3):116–9.
23. Wang C. Hyperbaric Oxygen for Treating Wounds. Arch Surg. 2003;138(3):272.
24. Thackham JA, McElwain DLS, Long RJ. The use of hyperbaric oxygen therapy to treat chronic wounds: A review. Wound Repair Regen. 2008 May;16(3):321–30.
25. Heyboer M, Sharma D, Santiago W, McCulloch N. Hyperbaric Oxygen Therapy: Side Effects Defined and Quantified. Adv Wound Care. 2017;6(6):210–24.
26. Wibowo A. Oksigen Hiperbarik: Terapi Percepatan Penyembuhan Luka. J Kedokt Dan Kesehat Univ Lampung. 2015;5(9):125–8.
27. Mathieu D, Marroni A, Kot J. Tenth european consensus conference on hyperbaric medicine: Recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Diving Hyperb Med. 2017;47(1):24–31.
