Local Hyperbaric Oxygen Therapy in the Treatment of Diabetic Foot Ulcers

Abstract

Background: Diabetes mellitus is one of the most common metabolic diseases. The most serious complication of diabetes is diabetic foot ulcer, which affects several million people around the world each year. In recent years, increasingly modern methods of physical medicine including hyperbaric oxygen therapy have been used often in the complex therapy of this complication. Methods: This study included 45 patients, 24 male (53.3%) and 21 female (46.6%), whose age was between 49 and 83 years (mean age: 66.7 ± 8.8 years) with diabetes lasting for 1.5–18 years, who underwent local hyperbaric oxygen therapy at the pressure of 2.5 ATA (30 exposures for 30 min each) due to diabetic foot ulcers. The progress in wound healing before and after the end of therapy was evaluated by computerized planimetry, and the pain intensity was assessed with the use of a VAS. Results: The analysis of results showed a statistically significant reduction in the wound surface area after the treatment, from 8.54 ± 3.34 cm to 4.23 ± 3.23 cm² (p = 0.000001). In 5 patients (11.1%), the wounds were healed completely. In 25 patients (55.5%), the topical state of the wound surface was significantly decreased by 50% on average. There was also a significant reduction in the perceived pain on the VAS in all examined patients from 4.64 ± 1.68 points before treatment to 1.51 ± 0.92 points after treatment (p = 0.000001). Conclusions: The application of local HBO therapy in the treatment of diabetic foot ulcers accelerates the ulcer healing process, as judged in objective planimetric assessment, and reduces the intensity of perceived pain ailments.

Effect of hyperbaric oxygen treatment on diabetic foot ulcers: A meta‐analysis

“…17 tests that were published between 1992 and 2022 were included in the meta‐analysis after an evaluation of 957 applicable exams since they fit the inclusion criteria 16,22–37 . Table 2 summarises the findings of these investigations.…”

“…The sample size ranged from 18 to 5466 people. 16,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] The examined data revealed that hyperbaric oxygen treatment had significantly higher healed ulcers, higher adverse events, lower mortality and higher ulcer area reduction compared to standard treatment in patients with diabetic foot ulcers. However, hyperbaric oxygen treatment and standard treatment had no significant difference in amputation, major amputation, minor amputation and healing time in patients with diabetic foot ulcers.…”

“…17 examinations from 1992 to 2022 were enrolled for the present meta‐analysis, comprising 7219 people with diabetic foot ulcers at the used studies' starting point, 1328 of them were using hyperbaric oxygen treatment and 5891 were using standard treatments. The sample size ranged from 18 to 5466 people 16,22–37 . The examined data revealed that hyperbaric oxygen treatment had significantly higher healed ulcers, higher adverse events, lower mortality and higher ulcer area reduction compared to standard treatment in patients with diabetic foot ulcers.…”

Effect of local oxygen therapy combined with vacuum sealing drainage on the healing of stage IV sacrococcygeal pressure ulcers

“…It exerts a beneficial impact on the entire process of open wound repair. Frykberg 17 found that local oxygen therapy effectively treats chronic wounds, while Pasek and Szajkowski 18 noted that local hyperbaric oxygen therapy accelerates the healing process of diabetic foot ulcers, as evidenced by objective evaluation, and reduces pain perception. The results of this study demonstrated that the study group exhibited shorter wound healing time and hospital stay compared to the control group ( p < 0.05), consistent with the findings of previous research.…”

Oxygen Therapy to Enhance Wound Healing After Revascularization

“…Local HBOT treatment is the new treatment for diabetic foot ulcer (DFU) and venous leg ulcers first published by Pasek J. et al in 2022 and 2023. 52,53 It reported promising results in wound area and pain reduction. However, the data on this new treatment in postrevascularization ulcers is unavailable.…”