Hyperbaric Oxygen: Silver Bullet for Diabetic Foot Ulcers

Abstract

Background: Hyperbaric Oxygen Therapy (HBOT) involves the administration of pure oxygen under high pressure conditions. HBOT is used as an adjuvant therapy for a variety of conditions; including chronic wounds, infections, stroke, tissue transplantation, anemia, cancer management, skin flaps & grafts, CO poisoning, air or gas embolism, decompression thickness, necrotizing fasciitis, crush injury, compartment syndrome, gas gangrene and autism.Objective: This prospective study was designed to evaluate the efficacy of HBOT as adjuvant treatment for diabetic foot ulcers in comparison to the conventional treatment. Patients and methods:This study comprised 82 diabetic patients, aged 38 to 72 years. Patients were randomized into two groups: Group A assigned to receive HBOT in combination with conventional wound care & group B received conventional wound care only for the treatment of diabetic foot ulcers. Outcomes were measured every week for 1 st two months during the treatment period and then at three-month intervals for one year. Ulcers were graded using Wagner classification system. Both groups were compared as regards healing time, need of amputation, quality of life. Results:The demographic characteristics of the 82 patients were 28 women (34%) and 54 men (65.9%), age range from 32 to 72 years. The median ulcer duration for both groups was 7.2 months, and the median ulcer area was 3.5 cm2. There was non-significant difference between both groups as regard demographic characteristics. Complete healing of the index ulcer was significantly faster in hyperbaric group 50% in comparison to 29% in group B. 2 major amputation were performed in HBOT group as compared to 3 cases in group B; all of them were Wagner grade IV. Five minor amputations were performed in each group during the 1st year of follow up. 63% of group A were satisfied as regard the management of their ulcers in comparison to 41% in group B.

Evaluation of the efficacy of hyperbaric oxygen therapy in the management of diabetic ulcer using Bates-Jensen wound assessment tool

“…Sharari et al . [ 18 ] conducted the study of Hyperbaric Oxygen: Silver Bullet for Diabetic Foot Ulcers in 82 patients and concluded that complete healing of the index ulcer was significantly faster in hyperbaric group 50% in comparison to 29% of those treated with conventional wound care. Two major amputations were performed in the HBOT group as compared to 3 cases in Group B; all of them were Wagner Grade IV ( P < 0.01).…”

“…Londahl et al . [ 18 ] showed that, at 3 and 6 months, there was no difference in ulcers healed between the HBOT and standard care groups. However, at 9 and 12 months, there was a significant difference in ulcers healed between the HBOT and standard care groups ( P < 0.01).…”