Evaluation of hyperbaric oxygen therapy effects in hard-to-heal wounds using thermal imaging and planimetry

Hyperbaric oxygen therapy (HBOT) uses higher atmospheric pressure air or pure oxygen on the human body to facilitate wound healing. Usually, planimetry and oximetry are used in the quantitative evaluation of hyperbaric oxygen therapy effects. However, a noninvasive, quick and easy-to-perform method of evaluation is still required. Thus, the main aim of our study was to assess the usefulness of thermal imaging in evaluating the effects of hyperbaric oxygen therapy on hard-to-heal wounds and to compare these results with that of parameters obtained from planimetry. The studies were performed at the Burn Treatment Center in Siemianowice Slaskie. The study included 60 patients (28 women and 32 men) aged between 48 and 82 who had hard-to-heal wounds localized on their lower extremities. Thermal images were carried out during three stages (I: 0–10 sessions, II: 10–20 sessions and III: more than 20 sessions of HBOT) of the treatment cycle, before entering and after leaving the hyperbaric chamber, respectively. The results showed that the temperature of the regions of interest decreased with the number of completed treatments. Moreover, obtained isotherm area of crura as well as temperature differences between the regions of interest surrounding the wound decreased with the duration of treatment, which suggests an improvement in microcirculation through neovascularization. Our research may lead to planning of a new diagnostic device that uses and correlates several imaging techniques. It seems that the combination of thermal imaging with planimetry can give the physician an additional diagnosis information, as well as information about the effects of therapy at the structural and metabolic level. In addition, both methods are noninvasive, painless, fast and safe, which is very important in the treatment of hard-to-heal wounds.