Hyperbaric Oxygen Stimulates Epidermal Reconstruction in Human Skin Equivalents

The crucial role of oxygen during the complex process of wound healing has been extensively described. In chronic or nonhealing wounds, much evidence has been reported indicating that a lack of oxygen is a major contributing factor. Although still controversial, the therapeutic application of hyperbaric oxygen (HBO) therapy can aid the healing of chronic wounds. However, how HBO affects reepithelization, involving processes such as keratinocyte proliferation and differentiation, remains unclear. We therefore used a three-dimensional human skin-equivalent (HSE) model to investigate the effects of daily 90-minute HBO treatments on the reconstruction of an epidermis. Epidermal markers of proliferation, differentiation, and basement membrane components associated with a developing epidermis, including p63, collagen type IV, and cytokeratins 6, 10, and 14, were evaluated. Morphometric analysis of hematoxylin and eosin-stained cross sections revealed that HBO treatments significantly accelerated cornification of the stratum corneum compared with controls. Protein expression as determined by immunohistochemical analysis confirmed the accelerated epidermal maturation. In addition, early keratinocyte migration was enhanced by HBO. Thus, HBO treatments stimulate epidermal reconstruction in an HSE. These results further support the importance of oxygen during the process of wound healing and the potential role of HBO therapy in cutaneous wound healing

In Vitro Models for Evaluation of Hyperbaric Oxygen Therapy in Wound Healing: A Review

Chronic ulcers are a major problem affecting a significant number of people around the world. The condition is difficult to heal and often leads to amputation. Hyperbaric oxygen (HBO) has been used clinically for the treatment of chronic ulcers and positive outcomes have been reported. However, owing to the lack of large randomised controlled trials and some conflicting data, controversy regarding the effectiveness of HBO in chronic wound healing persists. Besides randomised controlled clinical trials, in vitro studies hold promise in providing further insight into the role of HBO in wound healing and in aiding the establishment of a scientific foundation upon which more rational and efficacious HBO therapeutic regimes may be developed. The present article provides an overview of the available in vitro data on HBO with regards to wound healing. In particular, it focuses on experimental design issues and future opportunities using human skin equivalent models to study HBO-mediated wound healing