These problems are greatly increased due to the loss of the integumentary barrier to bacterial invasion and compromised or obstructed microvasculature. These problems further prevent humeral and cellular elements from reaching the burned tissue as well as delayed regeneration and healing. The therapy of burns must be directed at minimizing edema, preserving marginally viable tissue, enhancing host defenses, and promoting wound closure. A significant body of data clearly supports the efficacy of HBO 2 in the treatment of thermal injury. A reduction in fluid requirements, less conversion of partial to full thickness injury, preservation of marginally viable tissue, improved microcirculation, reduction in edema, faster epithelialization, less inflammatory response, enhancement of PMN killing, preservation of tissue creatine phosphate, adenosine triphosphate, and decreased wound lactate have all been reported.
Infection remains the leading cause of death from burn injuries that are treated at burn centers.
Therefore, control of infection is a major goal of therapy. An intact microvasculature is a critical factor in the ability to provide cellular and humeral elements to the site of the injury. Any improvement in the microvasculature, whether it be preservation of intact capillaries or control of interstitial edema, would favorably influence the burn outcome. This has lead to a reduced need for surgery, a reduced length of hospital stay, and a reduced mortality rate. HBO 2 therapy, used as an adjunct to traditional burn care, demonstrates greatest effects when initiated within the first 4 hours following the injury, or as quickly as possible.