Citation

Ozgok-Kangal K, Karatop-Cesur I, Ustunel C, Simsek K (2019) Chronıc Wound Formatıon on an Old Burn Scar after Surgıcal Incısıon and Hyperbarıc Oxygen Therapy: Case Report. Clin Med Rev Case Rep 6:282. doi.org/10.23937/2378-3656/1410282

Copyright

© 2019 Ozgok-Kangal K, et al. 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 credited.

CASE REPORT | OPEN ACCESS DOI: 10.23937/2378-3656/1410282

Chronıc Wound Formatıon on an Old Burn Scar after Surgıcal Incısıon and Hyperbarıc Oxygen Therapy: Case Report

Kubra Ozgok-Kangal1*, Iclal Karatop-Cesur2, Cesur Ustunel3 and Kemal Simsek4

1Assistant Professor, Department of Undersea and Hyperbaric Medicine, Gulhane Training and Research Hospital, Turkey

2Medical Doctor, Department of Undersea and Hyperbaric Medicine, Dıskapı Training and Research Hospital, Turkey

3Medical Doctor, Department of Undersea and Hyperbaric Medicine, Gulhane Training and Research Hospital, Turkey

4Associate Professor, Department of Undersea and Hyperbaric Medicine, Gulhane Training and Research Hospital, Turkey

Abstract

Chronic wounds fail to progress through the phases of wound healing; inflammation-proliferation-remodelling which are usually the result of persistent infection, malperfusion due to periwound hypoxia, cellular failure, and unrelieved pressure or repetitive trauma. In this report, we present a different rare cause of a chronic wound; a surgical incision on a post-burn scar during the surgery of transurethral resection of the prostate (TUR-P) because of urethral stricture. After six weeks, the surgical incision area was enlarged, and a chronic wound was formed with dimensions of 4*6 cm and a depth of 1 cm. The patient's wound was disrupted in the proliferation phase of wound healing. Hyperbaric oxygen (HBO) therapy was applied in order to provide a healthy granulation tissue development for a successful graft application by stimulating fibroblasts, providing adequate oxygen for collagen formation and enhanced neoangiogenesis. In the present case, repetitive debridements and negative pressure wound therapy (NPWT) were continued concurrently with HBO therapy. After twenty sessions of HBO therapy, graft application, and one-week immobilization, the wound was fully healed. Interventions on post-burn scars should be avoided as the tissue never regains the properties of uninjured skin. This tissue may have peripheral neuropathy which can lead to non-healing wounds. If the intervention is necessary, it should be done very carefully with minimal damage. The incisions should be deepened through unscarred tissues. The patient should be followed up closely. If the wound healing has delayed, additional appropriate methods should be considered like debridements, NPWT, HBO therapy, and grafts/flaps.