medicina Review The History and Development of Hyperbaric Oxygenation (HBO) in Thermal Burn Injury Christian Smolle 1,2 , Joerg Lindenmann 1,2,*, Lars Kamolz 1,2 and Freyja-Maria Smolle-Juettner 1,2,* 1 Division of Plastic, Aesthetic and Reconstructive Surgery, Division of Thoracic and Hyperbaric Surgery, Medical University Graz, Auenbruggerplatz 29, A-8036 Graz, Austria;
[email protected] (C.S.);
[email protected] (L.K.) 2 Division of Thoracic and Hyperbaric Surgery, Medical University Graz, Auenbruggerplatz 29, A-8036 Graz, Austria * Correspondence:
[email protected] (J.L.);
[email protected] (F.-M.S.-J.) Abstract: Background and Objectives: Hyperbaric oxygenation (HBO) denotes breathing of 100% oxygen under elevated ambient pressure. Since the initiation of HBO for burns in 1965, abundant experimental and clinical work has been done. Despite many undisputedly positive and only a few controversial results on the efficacy of adjunctive HBO for burn injury, the method has not yet been established in clinical routine. Materials and Methods: We did a retrospective analysis of the literature according to PRISMA—guidelines, from the very beginning of HBO for burns up to present, trying to elucidate the question why HBO is still sidelined in the treatment of burn injury. Results: Forty- seven publications (32 animal experiments, four trials in human volunteers and 11 clinical studies) fulfilled the inclusion criteria. Except four investigators who found little or no beneficial action, all were able to demonstrate positive effects of HBO, most of them describing less edema, improved healing, less infection or bacterial growth and most recently, reduction of post-burn pain.