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A three species model to simulate application of hyperbaric oxygen therapy to chronic wounds

Flegg, Jennifer, McElwain, Sean, Byrne, Helen M., & Turner, Ian W. (2009) A three species model to simulate application of hyperbaric oxygen therapy to chronic wounds. PLoS Computational Biology, 5(7), e1000451.

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Abstract

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 costeffectiveness of this therapy.

Impact and interest:

16 citations in Scopus
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15 citations in Web of Science®

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165 since deposited on 05 Aug 2009
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ID Code: 26668
Item Type: Journal Article
Keywords: Hyperbaric Oxygen Therapy, HBOT, Chronic wounds
DOI: 10.1371/journal.pcbi.1000451
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > ONCOLOGY AND CARCINOGENESIS (111200) > Radiation Therapy (111208)
Australian and New Zealand Standard Research Classification > MATHEMATICAL SCIENCES (010000) > OTHER MATHEMATICAL SCIENCES (019900)
Australian and New Zealand Standard Research Classification > BIOLOGICAL SCIENCES (060000) > BIOCHEMISTRY AND CELL BIOLOGY (060100)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Past > Schools > Mathematical Sciences
Copyright Owner: Copyright 2009 Flegg, McElwain, Byrne & Turner
Copyright Statement: Published under a Creative Commons Attribution Licence.
Deposited On: 06 Aug 2009 09:34
Last Modified: 29 Feb 2012 23:59

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