Cargando…

A Three Species Model to Simulate Application of Hyperbaric Oxygen Therapy to Chronic Wounds

Chronic wounds are a significant socioeconomic problem for governments worldwide. Approximately 15% of people who suffer from diabetes will experience a lower-limb ulcer at some stage of their lives, and 24% of these wounds will ultimately result in amputation of the lower limb. Hyperbaric Oxygen Th...

Descripción completa

Detalles Bibliográficos
Autores principales: Flegg, Jennifer A., McElwain, Donald L. S., Byrne, Helen M., Turner, Ian W.
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2710516/
https://www.ncbi.nlm.nih.gov/pubmed/19649306
http://dx.doi.org/10.1371/journal.pcbi.1000451
_version_ 1782169384888827904
author Flegg, Jennifer A.
McElwain, Donald L. S.
Byrne, Helen M.
Turner, Ian W.
author_facet Flegg, Jennifer A.
McElwain, Donald L. S.
Byrne, Helen M.
Turner, Ian W.
author_sort Flegg, Jennifer A.
collection PubMed
description Chronic wounds are a significant socioeconomic problem for governments worldwide. Approximately 15% of people who suffer from diabetes will experience a lower-limb ulcer at some stage of their lives, and 24% of these wounds will ultimately result in amputation of the lower limb. Hyperbaric Oxygen Therapy (HBOT) has been shown to aid the healing of chronic wounds; however, the causal reasons for the improved healing remain unclear and hence current HBOT protocols remain empirical. Here we develop a three-species mathematical model of wound healing that is used to simulate the application of hyperbaric oxygen therapy in the treatment of wounds. Based on our modelling, we predict that intermittent HBOT will assist chronic wound healing while normobaric oxygen is ineffective in treating such wounds. Furthermore, treatment should continue until healing is complete, and HBOT will not stimulate healing under all circumstances, leading us to conclude that finding the right protocol for an individual patient is crucial if HBOT is to be effective. We provide constraints that depend on the model parameters for the range of HBOT protocols that will stimulate healing. More specifically, we predict that patients with a poor arterial supply of oxygen, high consumption of oxygen by the wound tissue, chronically hypoxic wounds, and/or a dysfunctional endothelial cell response to oxygen are at risk of nonresponsiveness to HBOT. The work of this paper can, in some way, highlight which patients are most likely to respond well to HBOT (for example, those with a good arterial supply), and thus has the potential to assist in improving both the success rate and hence the cost-effectiveness of this therapy.
format Text
id pubmed-2710516
institution National Center for Biotechnology Information
language English
publishDate 2009
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-27105162009-08-01 A Three Species Model to Simulate Application of Hyperbaric Oxygen Therapy to Chronic Wounds Flegg, Jennifer A. McElwain, Donald L. S. Byrne, Helen M. Turner, Ian W. PLoS Comput Biol Research Article Chronic wounds are a significant socioeconomic problem for governments worldwide. Approximately 15% of people who suffer from diabetes will experience a lower-limb ulcer at some stage of their lives, and 24% of these wounds will ultimately result in amputation of the lower limb. Hyperbaric Oxygen Therapy (HBOT) has been shown to aid the healing of chronic wounds; however, the causal reasons for the improved healing remain unclear and hence current HBOT protocols remain empirical. Here we develop a three-species mathematical model of wound healing that is used to simulate the application of hyperbaric oxygen therapy in the treatment of wounds. Based on our modelling, we predict that intermittent HBOT will assist chronic wound healing while normobaric oxygen is ineffective in treating such wounds. Furthermore, treatment should continue until healing is complete, and HBOT will not stimulate healing under all circumstances, leading us to conclude that finding the right protocol for an individual patient is crucial if HBOT is to be effective. We provide constraints that depend on the model parameters for the range of HBOT protocols that will stimulate healing. More specifically, we predict that patients with a poor arterial supply of oxygen, high consumption of oxygen by the wound tissue, chronically hypoxic wounds, and/or a dysfunctional endothelial cell response to oxygen are at risk of nonresponsiveness to HBOT. The work of this paper can, in some way, highlight which patients are most likely to respond well to HBOT (for example, those with a good arterial supply), and thus has the potential to assist in improving both the success rate and hence the cost-effectiveness of this therapy. Public Library of Science 2009-07-31 /pmc/articles/PMC2710516/ /pubmed/19649306 http://dx.doi.org/10.1371/journal.pcbi.1000451 Text en Flegg et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Flegg, Jennifer A.
McElwain, Donald L. S.
Byrne, Helen M.
Turner, Ian W.
A Three Species Model to Simulate Application of Hyperbaric Oxygen Therapy to Chronic Wounds
title A Three Species Model to Simulate Application of Hyperbaric Oxygen Therapy to Chronic Wounds
title_full A Three Species Model to Simulate Application of Hyperbaric Oxygen Therapy to Chronic Wounds
title_fullStr A Three Species Model to Simulate Application of Hyperbaric Oxygen Therapy to Chronic Wounds
title_full_unstemmed A Three Species Model to Simulate Application of Hyperbaric Oxygen Therapy to Chronic Wounds
title_short A Three Species Model to Simulate Application of Hyperbaric Oxygen Therapy to Chronic Wounds
title_sort three species model to simulate application of hyperbaric oxygen therapy to chronic wounds
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2710516/
https://www.ncbi.nlm.nih.gov/pubmed/19649306
http://dx.doi.org/10.1371/journal.pcbi.1000451
work_keys_str_mv AT fleggjennifera athreespeciesmodeltosimulateapplicationofhyperbaricoxygentherapytochronicwounds
AT mcelwaindonaldls athreespeciesmodeltosimulateapplicationofhyperbaricoxygentherapytochronicwounds
AT byrnehelenm athreespeciesmodeltosimulateapplicationofhyperbaricoxygentherapytochronicwounds
AT turnerianw athreespeciesmodeltosimulateapplicationofhyperbaricoxygentherapytochronicwounds
AT fleggjennifera threespeciesmodeltosimulateapplicationofhyperbaricoxygentherapytochronicwounds
AT mcelwaindonaldls threespeciesmodeltosimulateapplicationofhyperbaricoxygentherapytochronicwounds
AT byrnehelenm threespeciesmodeltosimulateapplicationofhyperbaricoxygentherapytochronicwounds
AT turnerianw threespeciesmodeltosimulateapplicationofhyperbaricoxygentherapytochronicwounds