Topical oxygen therapy with Granulox®

No oxygen – no healing

Chronic wounds share a common challenge: a lack of oxygen reaching the wound. Wound healing requires large amounts of oxygen^{1, 2, 3} and healing is delayed when insufficient oxygen is available in the wound. A sustained failure of oxygenation at the tissue level – one of the barriers to healing for chronic wounds – is called hypoxia.¹

Adapted from Hauser 1987*

Patients with chronic wounds, such as pressure ulcers, diabetic foot ulcers and venous leg ulcers, suffer from underlying conditions that compromise the body’s ability to move oxygen to the wound. The situation is worsened by a combination of reduced blood flow in the region of the wound, due to underlying diseases, such as diabetes or chronic venous insufficiency, and less efficient^{2, 3} healing because the wound healing process consumes more oxygen.¹

*Hauser CJ. Tissue salvage by mapping of skin surface transcutaneous oxygen tension index. Archives of surgery (Chicago, Ill : 1960) 1987; 122(10): 1128-30.

Delivering oxygen for healing

Oxygen therapies can be delivered from the inside or outside (topically) of the body. Both approaches influence wound healing in different ways.¹

Oxygen provided from the inside via hyperbaric treatment improves oxygen supply thanks to improved blood oxygenation, but this effect is temporary and best used as an adjunct treatment.¹

Oxygen provided from the outside via various topical oxygen therapy methods facilitates the availability of oxygen to the base of the wound¹. This can lead to sustained healing but needs a vehicle for diffusing oxygen and penetrating the wound’s exudate layer. Wounds are not able to access oxygen from the air – the atmosphere is 21% oxygen, but the diffusion rate of oxygen is reduced substantially when a thin liquid layer is present in the wound. Haemoglobin helps to transport oxygen to low-oxygen environments in the wound bed, naturally moving to where oxygen is most needed.

Topical haemoglobin treatment is a simple way to facilitate oxygen diffusion directly within a chronic wound.¹ A haemoglobin spray can be applied to a wound as an adjunct to standard therapy¹ to accelerate oxygen delivery⁴.

Controlling for condition-specific symptoms is central to healing – but this plays just one role in a host of therapies that contribute to successful healing of chronic wounds.

Helping oxygen reach the wound bed

Using a topical, purified haemoglobin spray on hard-to-heal wounds provides a direct channel for oxygen-loaded haemoglobin to diffuse through wound exudate⁵ and reach the wound for increased oxygen saturation.

In vivo measurements have demonstrated the increase in tissue oxygenation following topical application of haemoglobin spray (Granulox) on chronic wounds:

1. Haemoglobin (Hb) spray (Granulox) is sprayed. Hb diffuses into the wound exudate and starts binding oxygen⁵ 
2. Oxygen is readily available at the surface, and Hb binds more oxygen⁵ 
3. Hb diffuses within the wound bed⁵ 
4. Driven by the oxygen gradient, Hb releases oxygen to hypoxic regions⁶, contributing to multiple cycles of binding and release of oxygen
5. The process is reversible, and Hb can absorb more oxygen where available

Granulox spray as topical oxygen therapy: Evidence-based oxygenation

Research supports the efficacy of wound oxygenation using facilitated diffusion. A EWMA group of experts has assessed the various treatment options available for addressing non-healing wounds¹, citing topical oxygen therapy as offering accelerated healing with a high level of accessibility and ease of use, even for at-home use by patients.

Clinical studies report that using Granulox haemoglobin spray leads to shorter healing time, reduced pain scores and total cost savings for healthcare providers compared to the standard of care⁴.

• Twice as many chronic wounds healed at 8–16 weeks compared to standard of care⁶   
• Time to heal diabetic foot ulcers was 50% shorter than with standard of care⁷   
• More than 70% of patients reported lower average pain scores at four weeks than with standard of care in chronic wounds⁴  
• 99% less slough in chronic wounds after four weeks compared to 33% with standard of care⁸  

Proven oxygenation in minutes

Granulox delivers proven oxygenation to the wound bed in minutes. Imaging shows (see below), for example, a leg ulcer before Granulox treatment. Large areas are visible showing areas that are deoxygenated or receiving no oxygen at all. The second image shows the same wound 20 minutes after Granulox is applied, increasing oxygenation from 56% to 79% saturation.

 3D imaging of a leg ulcer shows 56% O2 saturation, with large areas of deoxygenated Hb (blue) and no Hb (black)

79% saturation, 20 minutes after Granulox (p=0.043), with large areas of oxygenated Hb (red and white)

The patient perspective on topical oxygen therapy

For patients who have lived with chronic, hard-to-heal wounds, introducing a therapy that starts to show progress makes a difference to quality of life.

Granulox is safe, easy to use and cost-effective adjunctive therapy to standard wound care treatment.

Learn more about Granulox here