Oxygen and wound healing: a 2004 review

A review from Odense University Hospital, published in the World Journal of Surgery in 2004, sums up a principle known to surgery: a continuous supply of oxygen to the tissues through the microcirculation is vital for healing and for resistance to infection. It starts from a clinical observation: wounds do not heal in tissue that does not bleed. The author therefore considers it important to assess tissue perfusion and oxygenation in every kind of wound patient.

The biological mechanism

Oxygen is needed for three healing processes: collagen synthesis, which gives the repaired tissue its structure; killing bacteria by oxidation, one of the defences against infection; and the formation of new blood vessels that bring oxygen to the wound.

All three depend on how much oxygen reaches the tissue.

The author describes the surgical wound as an extra, temporary “organ” with higher metabolic needs than the surrounding tissue. It needs more oxygen than normal, and impaired circulation takes it away.

Extra oxygen: what the review says

External factors can significantly reduce the oxygen reaching the tissues. The review cites a study in which supplementary oxygen given around the operation halved the wound infection rate in patients undergoing colorectal resection.

On hyperbaric oxygen it is more cautious: it may help when the oxygen supply to the tissue is compromised, but for the author the definitive proof of its effect has yet to come. The conclusion is that delivering enough oxygen to the wound is vital for healing and resisting infection, and that assessing perfusion and oxygenation matters for the patient and for those treating them.

The Digital Twin lines up the data your devices write to your phone, such as steps, heart rate and sleep, and shows you how they change over time. It does not measure tissue oxygenation, it does not assess whether you are ready for surgery and it does not diagnose: this research describes groups of people, not you. Preparation for surgery is decided and followed by the care team.