The Role Of Oxygen In Optimizing Wound Environment

Introduction 

Have you ever wondered how our bodies heal wounds? Well, oxygen is the hero in this story. It helps build tissues, fight infections, and more. But here's the interesting part – there is a treatment that supercharges this process. We're diving into the world of wound healing, where oxygen takes centre stage, and we explore a special treatment called hyperbaric oxygen therapy.

Importance of wound healing

Do you know how your body starts fixing it when you get a cut or a scrape? Well, that is your body's way of healing. It is like a superhero in action. Here is how it works:

• Right after you get hurt, your body goes into action mode. It is like when you call for help when something's broken.
• The damaged parts of your body start to repair themselves. It's like when a handyman comes to fix a broken window or a leaky pipe.
• One of the most important jobs in this healing process is to build a protective barrier, like a fortress, around the wound. This barrier keeps bad stuff out, just like the walls of your house keep out intruders. Without it, you'd be open to infections, like an open door inviting trouble.
• As time goes on, your body works hard to make the wounded area strong again. It's similar to how your muscles get stronger when you exercise regularly.¹

Oxygen's role in wound healing

When your body faces a cut or injury, it is like a well-organized project with multiple phases. First, it stops the bleeding, then tackles inflammation, and eventually starts rebuilding. What's fascinating is that in this intricate process, oxygen takes on a starring role, playing a vital part in every step of the way.

Scientists have been studying how oxygen helps wounds heal for a long time, even back to the 1960s. Think of oxygen as the fuel your body needs to make this healing process work.

• Step 1: Stop the Bleeding: First, your body stops the bleeding. It's like turning off a faucet when water is spilling out. This helps to keep things under control.
• Step 2: The Repair Team Arrives: Then, your body sends in a repair team. They work like a construction crew. Their job is to fix what's broken and clean up the mess.
• Step 3: Building the Wall: One of the crucial parts is building a protective wall around the wound. This wall keeps out bad things like germs. It's like building a strong fence around your house to keep intruders away.
• Step 4: Getting Stronger: As time goes on, your body keeps working to make the wounded area strong again. It is similar to how you build up your muscles when you exercise.
• Step 5: Final Touches: In the end, your body does some final touches to make everything look and work just right. It is like putting the finishing touches on a masterpiece.²

One important thing to know is that at every step of this plan, oxygen is like the superhero that helps things happen. Without enough oxygen, your body can't do this healing job properly.

Oxygen delivery mechanisms 

Imagine if your body didn't get enough oxygen; it would be like a car running out of gas. Without enough oxygen, your body can quickly suffer damage that can't be fixed.

Low oxygen can happen for different reasons. It is  like a traffic jam stopping delivery trucks from reaching their destinations:

• Sometimes, there is not enough oxygen in the blood because of things like anaemia, which is like having fewer trucks carrying oxygen.
• Other times, oxygen can't get out of the delivery trucks (haemoglobin) to reach the cells, kind of like a locked treasure chest. This can happen if you're exposed to something harmful, like carbon monoxide.
• Lastly, low oxygen can occur if the roads (blood vessels) are blocked or damaged. It's like having a road closure, and the oxygen can't reach where it is needed.³

Oxygen gets around in two main ways:

• Most of it rides along with special vehicles called red blood cells. These cells are like oxygen taxis, carrying lots of oxygen to all parts of your body.
• A small amount of oxygen is like a free traveller; it's not in a taxi (red blood cell), but it's swimming in your blood.

To make sure oxygen gets to where it's needed, your lungs breathe in fresh oxygen, your heart pumps it around, your blood vessels are like the roads, and your red blood cells are the taxis. They all work together like a well-organised team to ensure you have the oxygen needed to stay healthy and active.

Effects of oxygen on wound healing 

Oxygen is like a healing helper. It is really important for making wounds get better. It does things like helping your body make new cells, grow blood vessels, and build proteins.

Cellular metabolism and energy production

Think of your body as a busy factory, and the energy it needs to run is called Adenosine Triphosphate (ATP). Each tiny factory is a cell, and they need certain things to make this energy.

One of the main ingredients your factory needs is oxygen. There are two main ways your body gets this.

• The oxygen breathe-in way (Aerobic)

When you take a breath, oxygen from the air goes into your lungs. Your blood, which is like a delivery truck, picks up this oxygen and takes it to your organs and muscles. They use this oxygen to make energy, like fueling a car with gasoline. This way is super efficient and gives your body a lot of energy, like a long-lasting battery.

• The oxygen-free way (Anaerobic)

Sometimes, your factories need to make energy quickly, like when you sprint. In these cases, they don't have time to wait for oxygen. So they use a different way, which is like making energy without the best fuel. It works, but not as well as with oxygen. It is like using a less efficient, temporary battery.⁴

• Why both ways matter

Imagine getting off a bus or a car. When you start walking, you might feel a bit tired because your factories are using the oxygen-free way at first, which isn't very efficient. However,  after a few minutes, they switch to the oxygen-breathing way, and you feel more energised. It is like switching from a small flashlight to a big, powerful torch.

Therefore, your body needs both of these energy-making methods. Oxygen is like the superhero that makes sure your factories keep running smoothly and efficiently.

Collagen synthesis and tissue regeneration 

Collagen is like the glue that helps wounds heal. It needs oxygen to form properly, just like how you need all the right ingredients to bake a cake.

However, when there is not enough oxygen (we call this hypoxia), collagen does not come together well, and new blood vessels struggle to grow. It's like trying to bake a cake without all the ingredients – it just will not turn out right. Having enough oxygen is like making sure you have all the ingredients for a successful healing process, while not having enough can lead to problems like slow healing and a higher risk of infection.⁵

Oxygen and infection control

Imagine your skin is like a busy city, and oxygen is the air everyone needs to breathe. Normally, your skin has good oxygen levels (like fresh air in the city), between 45 and 65 mm Hg. However, when you have a wound, especially in the middle part, without many blood vessels, oxygen levels drop to almost zero, like having no air to breathe.

When there's very little oxygen, it is like the city is running out of air. This makes the wound-healing process slow down a lot. It's similar to when traffic jams make you late for an appointment.

Another problem is bacteria. Some types of bacteria, especially those that don't need oxygen (we call them anaerobes), can infect wounds. This is like unwanted guests causing trouble in the city. Bacterial infections make wounds heal even slower and can turn them into long-term problems.⁶

But there's good news. By adding extra oxygen directly to the wound (we call this topical oxygen), we can improve the air quality, so to speak. This helps wounds heal faster, just like fresh air and fewer problems make a city run more smoothly.

Hypoxia and impaired healing 

As we said, the wound is like a repair project in a workshop. In the beginning, there's a shortage of air for the workers (your cells) because the wound area lacks oxygen. This condition is called "hypoxia."

Certain conditions like ageing and diabetes make it even tougher for the working cells to breathe. This slows down the healing process, much like having too few workers for a big job, and they can't catch their breath. Sometimes, a brief period of low oxygen signals the workers to speed up their work. It's similar to a deadline that pushes people to work faster.

However, once the workers get going, they need the right amount of air (oxygen) to maintain their pace. It's akin to fueling a car for a long journey.

Hyperbaric oxygen boost

In some cases, when there's not enough air, hyperbaric oxygen therapy provides the workers with extra oxygen. It is like a power-up that helps them work better and faster.⁷

Summary 

• Oxygen is vital for wound healing, aiding tissue building, infection control, and crucial biological processes.
• The wound healing process involves stopping bleeding, repairing tissues, and forming protective barriers, and oxygen plays a pivotal role in each step.
• Oxygen is transported by red blood cells and dissolves in plasma, ensuring it reaches all body parts.
• Oxygen fuels cellular energy production, which is essential for efficient cell function.
• Proper collagen formation, critical for healing, requires sufficient oxygen.
• Low oxygen slows healing and promotes harmful bacteria, but topical oxygen therapy can improve conditions.
• Prolonged hypoxia hinders healing, while short-term hypoxia can stimulate a faster response.
• In prolonged hypoxia cases, Hyperbaric Oxygen Therapy provides extra oxygen, acting like a power-up for the healing process.