Hyperbaric Oxygen in the Management of Chronic Diabetic Foot Ulcers

The Role of Hyperbaric Oxygen in the Treatment of Diabetic Foot Ulcers

“…A more recent double-blind clinical trial 62 has strengthened the evidence in favor of HBO. 64,65 All patients in this study had chronic, neuropathic, or neuroischemic wounds and vascular assessment had indicated that they were poor candidates for revascularization. An intention-to-treat analysis showed an improvement in ulcer healing (HBO group 52% vs control group 29%, P ¼ .03).…”

“…90 The total cost of the diabetic foot in the United States in 2007 was estimated to be $30 billion, of which $19 billion was due to foot ulceration and $11 billion to amputations. 64 In a more comprehensive analysis, the cost-effectiveness of add-on HBO has been estimated by the incremental cost per additional quality-adjusted life year (QALY). In the United States, this was $27 310 at the first year, $5166 after 5 years, and $2255 after 12 years.…”

Hyperbaric oxygen therapy in diabetic foot ulceration: Useless or useful? A battle

“…In conclusion, in 2010 Professor Boulton commented on the Löndahl study “this study puts HBO on firmer ground for diabetic patients with chronic foot ulcers who do not respond to standard therapy and in whom vascular reconstruction is not possible; as well as a need for further trials, firm criteria as to when to consider HBO therapy are now needed” . Several clinical studies, as well as real world data analyses, have been published since.…”

“…However, significant differences in wound healing did not appear until 9 months after entering the study . As one of the editors of Diabetes Care, and being impressed by the results , I commissioned an editorial to accompany this article : Lipsky and Berendt concluded that the study put HBO treatment for DFUs on firmer ground, but that the potential benefits come at a high cost and that further well‐designed studies are needed .…”

“…However, significant differences in wound healing did not appear until 9 months after entering the study 13 . As one of the editors of Diabetes Care, and being impressed by the results 16 , I commissioned an editorial to 2 of 4 LÖNDAHL AND BOULTON as a need for further trials, firm criteria as to when to consider HBO therapy are now needed" 16 . Several clinical studies, as well as real HBO as an adjunctive to vascular intervention as a part of the treatment strategy, people with ischemic DFUs were randomized to either potential benefits come at a high cost and that further well-designed studies are needed 22 .…”