A Retrospective Study of Patients With Diabetes Mellitus After Partial Foot Amputation and Hyperbaric Oxygen Treatment

Zgonis, Thomas; Garbalosa, Juan C.; Burns, Patrick R.; Vidt, Louis; Lowery, Clinton

doi:10.1053/j.jfas.2005.04.007

Cited by 30 publications

(30 citation statements)

References 28 publications

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“…Wattel et al reported a mean basal TcPO 2 of 32 mmHg in healers (n=15), compared with 12 mmHg in non-healers in a case-series of 20 patients (11 with diabetes and nine arterial insufficiency without diabetes) given adjunctive treatment with HBOT [10]. In a retrospective study of 35 patients who received 16-20 sessions of HBOT after partial foot amputation, healing was achieved in all patients with a TcPO 2 above 29 mmHg [11]. Oubre et al performed a retrospective analysis of 73 HBOT-treated patients (37 with diabetes) with 85 chronic lower extremity ulcers [12].…”

Section: Discussionmentioning

confidence: 99%

Relationship between ulcer healing after hyperbaric oxygen therapy and transcutaneous oximetry, toe blood pressure and ankle–brachial index in patients with diabetes and chronic foot ulcers

et al. 2010

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Aims/hypothesis The randomised, double-blind, placebocontrolled Hyperbaric Oxygen Therapy (HBOT) in Diabetic Patients with Chronic Foot Ulcers (HODFU) study showed beneficial effect of HBOT. As this treatment is expensive and time-consuming, being able to select patients for therapy would be very useful. The aim of this study was to evaluate whether circulatory variables could help in predicting outcome of HBOT. Methods All HODFU study participants who completed therapy, predefined as receiving at least 36 out of 40 scheduled HBOT/placebo sessions, were included in this study (n=75). Baseline transcutaneous oximetry (TcPO 2 ), toe blood pressure (TBP) and ankle-brachial index (ABI) were measured. Ulcer healing rate was registered at the 9-month follow-up visit. An ulcer was considered healed when it was completely epithelialised and remained so at the 12-month follow-up. ResultsIn the HBOT group TcPO 2 were significantly lower for patients whose ulcer did not heal as compared with those whose ulcers healed. A significantly increased healing frequency was seen with increasing TcPO 2 levels in the HBOT group (TcPO 2 /healing rate: <25 mmHg/0%; 26-50 mmHg/50%; 51-75 mmHg/73%; and >75 mmHg/ 100%). No statistically significant relation between the level of TBP or ABI and healing frequency was seen. Conclusions/interpretation Our results indicate that TcPO 2 in contrast to ABI and TBP correlates to ulcer healing following HBOT. We suggest HBOT as a feasible adjunctive treatment modality in diabetic patients with chronic non-healing foot ulcers when basal TcPO 2 at the dorsum of the foot is above 25 mmHg. Trial registration NCT00953186 Funding Mrs

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Section: Discussionmentioning

confidence: 99%

Relationship between ulcer healing after hyperbaric oxygen therapy and transcutaneous oximetry, toe blood pressure and ankle–brachial index in patients with diabetes and chronic foot ulcers

et al. 2010

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“…A study assessing the relationship between HBOT and patient outcome following partial foot amputation over a 58 A successful outcome was achieved, with a mean number of 20 treatments and 44 days to reach that endpoint compared with a mean of 16 treatments and 216 days in the failed group. The authors stressed that this study was intended to provide a starting point on which future research could be based.…”

Section: Retrospective Studies In Diabetic Ulcersmentioning

confidence: 99%

“…The authors stressed that this study was intended to provide a starting point on which future research could be based. 58 Fife et al investigated outcomes for 971 patients with diabetic lower extremity ulcers who received HBOT. 59 They reported that 717 (73.8%) patients had improved healing with 34 HBOT treatments.…”

Section: Retrospective Studies In Diabetic Ulcersmentioning

confidence: 99%

Safety and efficacy of hyperbaric oxygen therapy in chronic wound management: current evidence

Eggleton¹,

Bishop²,

Smerdon³

2015

CWCMR

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Abstract:The breathing of pure oxygen under pressure to treat tissue damage has been employed for almost 45 years and has been investigated in prospective, retrospective, and randomized controlled trials. The physiological effects of oxygen treatment on wound tissue are profound, and include activation of immune cells, changes in cytokine production, and modulation of inflammatory and bactericidal mediators. Hyperbaric oxygen influences the biochemistry of whole cells, altering cell proliferation, angiogenesis, clotting, and tissue regeneration. The precise effects of hyperbaric oxygen on individual cell types and tissues are only beginning to be revealed in both animal and human studies. Many independent studies using hyperbaric oxygen adjunctively with standard wound care have observed improved healing, in particular for diabetic foot ulcers, and can result in a significant reduction in major amputations. Side effects occur infrequently, but myopia, ear barotrauma, and rarely oxygen toxicity have been reported. As antibiotics become less available, and clinician time and complex dressings become more expensive, use of hyperbaric oxygen as a means of treating a variety of wound types may become an increasingly appropriate option for treatment.

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“…A retrospective study assessing the relationship between HBO and patient outcome following partial foot amputation(37) found that 70% of patients (35 patients with 40 wounds) experienced healing or no further surgical procedures required to heal the site after HBO. Patients with a successful outcome had a mean number of 20 HBO treatments and took a mean of 44 days to reach that point compared with the failed group who received a mean of 16 HBO treatments and took 216 days to final outcome.…”

Section: Retrospective Studiesmentioning

confidence: 99%

Diabetic foot ulcers treated with hyperbaric oxygen therapy: a review of the literature

Bishop

Mudge

2012

International Wound Journal

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Hyperbaric oxygen therapy (HBO) has been used as an adjunct for healing diabetic foot ulcers (DFUs) for decades. However, its use remains controversial. A literature search was conducted to locate clinical studies and assess the available evidence. Ten prospective and seven retrospective studies evaluating HBO for DFUs were located. These were reviewed and the outcomes were discussed. One study reported no difference in outcomes between patients receiving hyperbaric oxygen and the control group. However, their regime differed from all other studies in that the patients received hyperbaric oxygen twice rather than once daily. Reduced amputation rates and improved healing were the most common outcomes observed.

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A Retrospective Study of Patients With Diabetes Mellitus After Partial Foot Amputation and Hyperbaric Oxygen Treatment

Cited by 30 publications

References 28 publications

Relationship between ulcer healing after hyperbaric oxygen therapy and transcutaneous oximetry, toe blood pressure and ankle–brachial index in patients with diabetes and chronic foot ulcers

Relationship between ulcer healing after hyperbaric oxygen therapy and transcutaneous oximetry, toe blood pressure and ankle–brachial index in patients with diabetes and chronic foot ulcers

Safety and efficacy of hyperbaric oxygen therapy in chronic wound management: current evidence

Diabetic foot ulcers treated with hyperbaric oxygen therapy: a review of the literature

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