Abstract: Open wounds subjected to cold stress are an extremely dangerous form of battlefield injury, and are threating people suffering from exposure in wild areas. Among emergency treatments, hyperbaric oxygen (HBO) therapy has been found to be safe and effective in wound healing. However, the best intervention time for HBO is still unclear. In this study, by using a murine dorsal full-thickness wound model under cold stress, we compared three kinds of intervention strategies for HBO: 0, 24 and 48 hours after wounding. The results showed that immediate (0 h) HBO treatment had the best outcomes  to reduce death rate (0-hHBO 33% vs. control 100%) on day 5, when wound closure rates were 85%. Further whole blood testing and immunochemical detection revealed 0-hHBO therapy improved hematological indicators and exerted anti-apoptotic effects, especially in epidermal stem cells. The results provide important clues for clinical application of HBO.

Key words: hyperbaric oxygen therapy, survival rate, wound healing, cold stress, time course

摘要： 暴露于寒冷环境下的皮肤开放性伤口是一种高度危险的战场创伤，威胁在室外作业的人员健康。紧急治疗中，高压氧(hyperbaric oxygen, HBO)治疗已经证实能够安全有效地促进皮肤伤口愈合。然而，HBO治疗的最佳干预时间说法仍然并不统一。使用冷应激下的小鼠背部皮肤全层缺损创面模型，比较了HBO治疗的3种干预策略，即分别为创伤后0、24和48 h介入HBO。结果显示，创后立即实施高压氧治疗(0-hHBO组)降低死亡率的效果最佳，小鼠死亡率为33%，而对照组死亡率为100%，且0-hHBO组创面愈合率第5天已达到85%。进一步的血常规和组织免疫化学检测显示，0-hHBO治疗组改善了血液指标，并发挥了一定的抗凋亡作用，这种作用尤其在表皮干细胞中更为明显。因此，研究结果将为HBO的临床应用提供重要的实验数据和线索。

关键词: 高压氧治疗, 存活率, 伤口愈合, 寒冷应激, 介入时间