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    A Three Species Model to Simulate Application of Hyperbaric Oxygen Therapy to Chronic Wounds

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    Author
    Flegg, JA; McElwain, DLS; Byrne, HM; Turner, IW
    Date
    2009-07-01
    Source Title
    PLoS Computational Biology
    Publisher
    PUBLIC LIBRARY SCIENCE
    University of Melbourne Author/s
    Flegg, Jennifer
    Affiliation
    School of Mathematics and Statistics
    Metadata
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    Document Type
    Journal Article
    Citations
    Flegg, J. A., McElwain, D. L. S., Byrne, H. M. & Turner, I. W. (2009). A Three Species Model to Simulate Application of Hyperbaric Oxygen Therapy to Chronic Wounds. PLOS COMPUTATIONAL BIOLOGY, 5 (7), https://doi.org/10.1371/journal.pcbi.1000451.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/256592
    DOI
    10.1371/journal.pcbi.1000451
    Abstract
    Chronic wounds are a significant socioeconomic problem for governments worldwide. Approximately 15% of people who suffer from diabetes will experience a lower-limb ulcer at some stage of their lives, and 24% of these wounds will ultimately result in amputation of the lower limb. Hyperbaric Oxygen Therapy (HBOT) has been shown to aid the healing of chronic wounds; however, the causal reasons for the improved healing remain unclear and hence current HBOT protocols remain empirical. Here we develop a three-species mathematical model of wound healing that is used to simulate the application of hyperbaric oxygen therapy in the treatment of wounds. Based on our modelling, we predict that intermittent HBOT will assist chronic wound healing while normobaric oxygen is ineffective in treating such wounds. Furthermore, treatment should continue until healing is complete, and HBOT will not stimulate healing under all circumstances, leading us to conclude that finding the right protocol for an individual patient is crucial if HBOT is to be effective. We provide constraints that depend on the model parameters for the range of HBOT protocols that will stimulate healing. More specifically, we predict that patients with a poor arterial supply of oxygen, high consumption of oxygen by the wound tissue, chronically hypoxic wounds, and/or a dysfunctional endothelial cell response to oxygen are at risk of nonresponsiveness to HBOT. The work of this paper can, in some way, highlight which patients are most likely to respond well to HBOT (for example, those with a good arterial supply), and thus has the potential to assist in improving both the success rate and hence the cost-effectiveness of this therapy.

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