The Compatibility of a Variety of Wound Care Dressings with Hyperbaric Oxygen Therapy

Hyperbaric Oxygen Therapy (HBO) is widely used in the medical arena.  The question of dressing compatibility is a common one.  Though obtaining information on Hyperbaric Oxygen Therapy (HBO) compatibility is a bit challenging, guidelines do exist that provide insight into this issue.  The National Fire Protection Agency (NFPA) Code 99, chapter 20 addresses HBO compatibility.  We know from this document that certain materials are potential hazards. Even w/ these guidelines there is a critical need for actual test data on specific materials.  The purpose of this study was to evaluate a variety of wound dressings under conditions of HBO therapy.  In this study dressings such as wound contact layers, foams, topical antimicrobials, and collagen as well as skin care formulations were evaluated for HBO compatibility. A given dressing was tested for flammability potential via 3 individual assays (oxygen index, auto ignition & Bomb Calorimetery).  The values from these assays were then used to determine the ‘acceptability index’ of the dressing.  This index is then compared to the index of other dressings/formulaions w/ known compatibility (or incompatibility) w/ HBO. All assays were performed in triplicate. From the data it was determined that the majority of the dressings under test were compatible with HBO. Based upon the data, it seems possible that the amount of a potentially hazards material may play a role.  Other formulation components might play a role as well.  For instance, a skin care formulation that does contain petrolatum may contain a high level of water as well.  The water may help to reduce the risk of flammability/combustibility of the overall formulation.  To be 100% certain, suspect dressings/formulations need to be evaluated individually. It is hoped that studies of this type will allow for enhanced clinician education, improve patient safety and prove beneficial to facilities.