Role of oxygen in wound healing

Ibby Younis

Consultant Plastic and Reconstructive Surgeon, Royal Free London NHS Foundation Trust, London, UK

Published Online:19 May 2020https://doi.org/10.12968/jowc.2020.29.Sup5b.S4

Abstract

Not only does oxygen play an essential role in each stage of the wound healing process. It also helps to increases host resistance to infection. Any impairment to the oxygen supply can therefore delay healing. This article explores the affects of oxygen on the wound cells and tissue, and explains how an adequate supply is required for granulation tissue formation and epithelialisation to occur

References

1. Sen C. Wound healing essentials: let there be oxygen. Wound Repair Regen. 2009;17:1–18. https://doi.org/10.1111/j.1524-475X.2008.00436.x Crossref, Medline, Google Scholar
2. Gordillo G, Sen C. Revisiting the essential role of oxygen in wound healing. Am J Surg. 2003;186:259–63. https://doi.org/10.1016/s0002-9610(03)00211-3 Crossref, Medline, Google Scholar
3. Shah J. Correction of hypoxia, a critical element for wound bed preparation guidelines: Timeo2 principle of wound bed preparation. J Am Col Certif Wound Spec. 2011;3:26–32. https://doi.org/10.1016/j.jcws.2011.09.001 Crossref, Medline, Google Scholar
4. Stücker M, Struk A, Altmeyer P et al.. The cutaneous uptake of atmospheric oxygen contributes significantly to the oxygen supply of human dermis and epidermis. J Physiol. 2002;538:985–94. https://doi.org/10.1113/jphysiol.2001.013067 Crossref, Medline, Google Scholar
5. Ichioka S, Ando T, Shibata M et al.. Oxygen consumption of keloids and hypertrophic scars. Ann Plast Surg. 2008;60:194–7. https://doi.org/10.1097/SAP.0b013e318053ec1d Crossref, Medline, Google Scholar
6. Lodish H, Berk A, Zipursky S et al.. Molecular cell biology. (4th edn). W. H. Freeman, 2000 Google Scholar
7. Bishop A. Role of oxygen in wound healing. J Wound Care. 2008;17:399–402. https://doi.org/10.12968/jowc.2008.17.9.30937 Link, Google Scholar
8. Tandara A, Mustoe T. Oxygen in wound healing: more than a nutrient. World J Surg. 2004;28:294–300. https://doi.org/10.1007/s00268-003-7400-2 Crossref, Medline, Google Scholar
9. Whitney J. Physiologic effects of tissue oxygenation on wound healing. Heart Lung. 1989;18:466–74 Medline, Google Scholar
10. Greif R, Akça O, Horn E-P et al.. Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection. New Eng J Med. 2000;342:161–7. https://doi.org/10.1056/NEJM200001203420303 Crossref, Medline, Google Scholar
11. LaVan F, Hunt T. Oxygen and wound healing. Clin Plast Surg. 1990;17:463–72 Medline, Google Scholar
12. Sheffield PJ. Tissue oxygen measurements. In: Problem wounds: the role of oxygen. Davis JCHunt TK (eds). Elsevier, 1988 Google Scholar
13. Patel V, Chivukula I, Roy S et al.. Oxygen: from the benefits of inducing VEGF expression to managing the risk of hyperbaric stress. Antioxid Redox Signal. 2005;7:1377–87. https://doi.org/10.1089/ars.2005.7.1377 Crossref, Medline, Google Scholar
14. Kominsky D, Campbell E, Colgan S. Metabolic shifts in Immunity and Inflammation. J Immunol. 2010;184:4062–8. https://doi.org/10.4049/jimmunol.0903002 Crossref, Medline, Google Scholar
15. Sen CK. The general case for redox control of wound repair. Wound Repair Regen. 2003;11:431–8. https://doi.org/10.1046/j.1524-475x.2003.11607.x Crossref, Medline, Google Scholar
16. Babior B. Oxygen-dependent microbial killing by phagocytes (first of two parts). N Engl J Med. 1978;298:659–68. https://doi.org/10.1056/NEJM197803232981205 Crossref, Medline, Google Scholar
17. Lambeth J, Kawahara T, Diebold B. Regulation of Nox and Duox enzymatic activity and expression. Free Radic Biol Med. 2007;43:319–31. https://doi.org/10.1016/j.freeradbiomed.2007.03.028 Crossref, Medline, Google Scholar
18. Allen D, Maguire J, Mahdavian M et al.. Wound hypoxia and acidosis limit neutrophil bacterial killing mechanisms. Arch Surg. 1997;132:991–6. https://doi.org/10.1001/archsurg.1997.01430330057009 Crossref, Medline, Google Scholar
19. Hopf H, Hunt T, West J et al.. Wound tissue oxygen tension predicts the risk of wound infection in surgical patients. Arch Surg. 1997;132:997–1004; discussion 1005. https://doi.org/10.1001/archsurg.1997.01430330063010 Crossref, Medline, Google Scholar
20. Prockop D, Kivirikko K, Tuderman L et al.. The biosynthesis of collagen and its disorders (first of two parts). N Engl J Med. 1979;301:13–23. https://doi.org/10.1056/NEJM197907053010104 Crossref, Medline, Google Scholar
21. Hunt T, Zederfeldt B, Goldstick T. Oxygen and healing. Am J Surg. 1969;118:521–5. https://doi.org/10.1016/0002-9610(69)90174-3 Crossref, Medline, Google Scholar
22. Chin G, Schultz G, Chegini N et al.. Biochemistry of wound healing in wound care practice. In: Wound care practice. Sheffield PJFife CESmith APS (eds). Best Publishing, 2004 Google Scholar
23. Jonsson K, Jensen J, Goodson W et al.. Tissue oxygenation, anemia, and perfusion in relation to wound healing in surgical patients. Ann Surg 1991;214:605–13 Crossref, Medline, Google Scholar
24. Robins S. Biochemistry and functional significance of collagen cross-linking. Biochem Soc Trans. 2007;35:849–52. https://doi.org/10.1042/BST0350849 Crossref, Medline, Google Scholar
25. Hunt T, Pai M. The effect of varying ambient oxygen tensions on wound metabolism and collagen synthesis. Surg Gynecol Obstet. 1972;135:561–7 Medline, Google Scholar
26. Wattel F, Mathieu D, Coget JM, Billard V. Hyperbaric oxygen therapy in chronic vascular wound management. Angiology. 1990; 41(1):59–65 Crossref, Medline, Google Scholar
27. Efrati S, Bergan J, Fishley G, Tishler M, Golik A, Gall N. Hyperbaric oxygen therapy for nonhealing vasculitic ulcers. Clin Exp Dermatol. 2007; 32(1): 12–7 Medline, Google Scholar
28. Semenza G. Regulation of hypoxia-induced angiogenesis: a chaperone escorts VEGF to the dance. J Clin Invest 2001;108:39–40. https://doi.org/10.1172/JCI13374 Crossref, Medline, Google Scholar
29. Tickle J. A topical haemoglobin spray for oxygenating pressure ulcers: a pilot study. Br J Community Nurs. 2015;Suppl Wound Care:S12, S14-18. https://doi.org/10.12968/bjcn.2015.20.Sup3.S12 Link, Google Scholar
30. Forsythe J, Jiang B, Iyer N et al.. Activation of vascular endothelial growth factor gene transcription by hypoxia-inducible factor 1. Mol Cell Biol. 1996;16:4604–13. https://doi.org/10.1128/mcb.16.9.4604 Crossref, Medline, Google Scholar
31. Dimitrijevich S, Paranjape S, Wilson J et al.. Effect of hyperbaric oxygen on human skin cells in culture and in human dermal and skin equivalents. Wound Repair Regen. 1999;7:53–64. https://doi.org/10.1046/j.1524-475x.1999.00053.x Crossref, Medline, Google Scholar
32. Hopf H, Gibson J, Angeles A et al.. Hyperoxia and angiogenesis. Wound Repair Regen. 2005;13:558–64. https://doi.org/10.1111/j.1524-475X.2005.00078.x Crossref, Medline, Google Scholar
33. Maniscalco W, Watkins R, Finkelstein J et al.. Vascular endothelial growth factor mRNA increases in alveolar epithelial cells during recovery from oxygen injury. Am J Respir Cell Mol Biol. 1995;13:377–86. https://doi.org/10.1165/ajrcmb.13.4.7546767 Crossref, Medline, Google Scholar
34. Deaton P, McKellar C, Culbreth R et al.. Hyperoxia stimulates interleukin-8 release from alveolar macrophages and U937 cells: attenuation by dexamethasone. Am J Physiol. 1994;267:L187–192. https://doi.org/10.1152/ajplung.1994.267.2.L187 Medline, Google Scholar
35. Sheikh A, Gibson J, Rollins M et al.. Effect of hyperoxia on vascular endothelial growth factor levels in a wound model. Arch Surg. 2000;135:1293–7. https://doi.org/10.1001/archsurg.135.11.1293 Crossref, Medline, Google Scholar
36. Kimmel HM, Grant A, Ditata J. The presence of oxygen in wound healing. Wounds. 2016;28:264–70 Medline, Google Scholar
37. Rodriguez PG, Felix FN, Woodley DT et al.. The role of oxygen in wound healing: a review of the literature. Dermatol Surg. 2008;34:1159–69. https://doi.org/10.1111/j.1524-4725.2008.34254.x Crossref, Medline, Google Scholar
38. Juránek I, Bezek S. Controversy of free radical hypothesis: reactive oxygen species-cause or consequence of tissue injury? Gen Physiol Biophys. 2005;24:263–78 Medline, Google Scholar
39. Sen C, Roy S. Redox signals in wound healing. Biochim Biophys Acta. 2008;1780:1348–61. https://doi.org/10.1016/j.bbagen.2008.01.006 Crossref, Medline, Google Scholar
40. Diegelmann R, Evans M. Wound healing: an overview of acute, fibrotic and delayed healing. Front Biosci. 2004;9:283–9. https://doi.org/10.2741/1184 Crossref, Medline, Google Scholar
41. Ortmann B, Druker J, Rocha S. Cell cycle progression in response to oxygen levels. Cell Mol Life Sci. 2014;71:3569–82. https://doi.org/10.1007/s00018-014-1645-9 Crossref, Medline, Google Scholar
42. Vande Berg J, Robson M. Arresting cell cycles and the effect on wound healing. Surg Clin North Am. 2003;83:509–20. https://doi.org/10.1016/S0039-6109(02)00195-0 Crossref, Medline, Google Scholar
43. Gottrup F. Physiology and measurement of tissue perfusion. Ann Chir Gynaecol. 1994;83:183–9 Medline, Google Scholar
44. Im M, Hoopes J. Energy metabolism in healing skin wounds. J Surg Res. 1970;10:459–64. https://doi.org/10.1016/0022-4804(70)90070-3 Crossref, Medline, Google Scholar
45. Matsuda T, Clark N, Hariyani G et al.. The effect of burn wound size on resting energy expenditure. J Trauma. 1987;27:115–8. https://doi.org/10.1097/00005373-198702000-00002 Crossref, Medline, Google Scholar
46. Edwards R, Harding K. Bacteria and wound healing. Curr Opin Infect Dis. 2004;17:91–6. https://doi.org/10.1097/00001432-200404000-00004 Crossref, Medline, Google Scholar
47. Gottrup F, Dissemond J, Baines C et al.. Use of oxygen therapies in wound healing. J Wound Care. 2017;26: S1–43. https://doi.org/10.12968/jowc.2017.26.Sup5.S1 Link, Google Scholar
48. Jünger M, Hahn M, Klyscz T, Steins A. Microangiopathy in the pathogenesis of chronic venous insufficiency. Curr Probl Dermatol. 1999;27:124–9. https://doi.org/10.1159/000060637 Crossref, Medline, Google Scholar
49. Wounds International. Best practice guidelines wound management in diabetic foot ulcers. 2013. https://tinyurl.com/y9e2tfbh (accessed 3 February 2020) Google Scholar
50. Vasconcelos A, Cavaco-Paulo A. Wound dressings for a proteolytic-rich environment. Appl Microbiol Biotechnol. 2011; 90(2):445–60. https://doi.org/10.1007/s00253-011-3135-4 Crossref, Medline, Google Scholar
51. Dunnill C, Patton T, Brennan J et al.. Reactive oxygen species (ROS) and wound healing: the functional role of ROS and emerging ROS-modulating technologies for augmentation of the healing process. Int Wound J. 2017; 14(1):89–96. https://doi.org/10.1111/iwj.12557] Crossref, Medline, Google Scholar
52. Kaufman H, Gurevich M, Tamir E et al.. Topical oxygen therapy stimulates healing in difficult, chronic wounds: a tertiary centre experience. J Wound Care. 2018;27:426–33. https://doi.org/10.12968/jowc.2018.27.7.426 Link, Google Scholar

1 May 2020Volume 29Issue Sup5b

ISSN (print): 0969-0700
ISSN (online): 2052-2916

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Published online 19 May 2020

Published in print 1 May 2020

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