Utilizing Variable Flow Rate Continuous Diffusion of Oxygen to Modulate Exudate and Iterate Pain in Chronic Wounds

Exudate and pain are two variable factors which can significantly impact wound healing. Continuous Diffusion of Oxygen (CDO) Therapy* has been shown to significantly decrease pain and increase wound healing.[1],[2] Some CDO devices have the ability to adjust oxygen flow from 3-15 mL/hr based on wound size and response.
 
Eight wounds were analyzed to examine oxygen flow rates and wound response with regards to exudate and pain.
 
Exudate and pain levels were tracked on day of CDO placement and weekly for the first six weeks. Exudate was tracked as high, medium, low or scant. Pain was measured from 0-10, 10 being highest. Sharp debridement was performed before placement of the oxygen diffusion dressing and CDO therapy. Oxygen settings for all eight wounds were 8 mL/hr at initiation. Once exudate moderated, an increase of flow rate by 4 ml/hr weekly was delivered. Compression and offloading were applied as required. Dressing changes were performed 2-3 times per week depending on dressing saturation.
 
Each wound responded with increased exudate between weeks one to three. Exudate levels then moderated regardless of increase in oxygen thereafter, for all but two patients. Those patients required a decrease in oxygen until exudate levels were stabilized.
 
Three of eight wounds presented with pain, one of which had a pain level of 10. Two of the three patients were pain free by week two of therapy. The final wound took until four weeks prior to closure to achieve 0 pain.
 
The ability to modulate flow rate of oxygen as a response to exudate and pain is essential. Though an increase in exudate during weeks one to three is expected, heavy exudate can be managed by decreasing oxygen levels. Conversely, increasing flow rates resulted in an overall decrease in pain. Oxygen flow rates appear to have direct impacts on wound response for both pain and exudate control.
 
 

Trademarked Items (if applicable): *CDO Therapy refers to OxyGeni, ElechtroChemical Oxygen Concepts (EO2), San Antonio Texas.

References (if applicable): 1. Bowen, J. etal. Effect of Continuous Diffusion of Oxygen on Pain in Treatment of Chronic Wounds. WiltshireLifeSupplement- Wound Care Central September 2018 Vol 2: Issue 4

2. Niederauer, MQ, Michalek, JE, Liu, Q, Papas, KK, Lavery, LA & Armstrong, DG 2018, 'Continuous diffusion of oxygen improves diabetic foot ulcer healing when compared with a placebo control: A randomised, double-blind, multicentre study' Journal of wound care, vol. 27, pp. S30-S45.