Response to Comments on Fedorko et al. Hyperbaric Oxygen Therapy Does Not Reduce Indications for Amputation in Patients With Diabetes With Nonhealing Ulcers of the Lower Limb: A Prospective, Double-Blind, Randomized Controlled Clinical Trial. Diabetes Care 2016;39:392–399

Fedorko, Ludwik; Bowen, James M.; Jones, Wilhelmine; Oreopoulos, George; Goeree, Ron; Hopkins, Robert; O’Reilly, Daria

doi:10.2337/dci16-0006

Cited by 7 publications

(14 citation statements)

References 7 publications

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“…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.…”

Section: Discussionmentioning

confidence: 99%

“…Our results oppose a systematic review 41 that found no distinction between the hyperbaric oxygen treatment and standard treatment groups in terms of side effects. Studies that were included had documented negative effects, including oxygen toxicity, oxygen-induced seizure, 27 ocular effects, barotraumatic lesions, harm to the ear, 23,24,27,31,33 hypoglycemia 27,31 and cataracts. 16,27 Barotrauma which affects air-filled cavities in the human body, particularly the middle ear, lungs and sinuses, is the most frequent adverse impact linked to hyperbaric oxygen treatment.…”

Section: Discussionmentioning

confidence: 99%

“…It happens as a result of compression. 31 Barotrauma is typically simply treatable and recoverable without the need for therapeutic intervention. The most uncommon conditions to occur are pulmonary barotrauma, injuries, or fire in the chamber; these are the main side effects.…”

Section: Discussionmentioning

confidence: 99%

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

Imam,

Almutairi,

Alhajri

et al. 2023

International Wound Journal

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The meta‐analysis aimed to assess the effect of hyperbaric oxygen treatment on diabetic foot ulcers. Using dichotomous or contentious random or fixed effect models, the outcomes of this meta‐analysis were examined and the odds ratio (OR) and the mean difference (MD) with 95% confidence intervals (CIs) were computed. 17 examinations from 1992 to 2022 were enrolled for the present meta‐analysis, including 7219 people with diabetic foot ulcers. Hyperbaric oxygen treatment had a significantly higher healed ulcer (OR, 14.39; 95% CI, 4.02–51.52, p < 0.001), higher adverse event (OR, 2.14; 95% CI, 1.11–4.11, p = 0.02), lower mortality (OR, 0.22; 95% CI, 0.07–0.71, p = 0.01) and higher ulcer area reduction (MD, 23.39; 95% CI, 11.79–34.99, p < 0.001) compared to standard treatment in patients with diabetic foot ulcers. However, hyperbaric oxygen treatment and standard treatment had no significant difference in amputation (OR, 0.62; 95% CI, 0.22–1.75, p = 0.37), major amputation (OR, 0.59; 95% CI, 0.18–1.92, p = 0.38), minor amputation (OR, 0.64; 95% CI, 0.15–2.66, p = 0.54) and healing time (MD, −0.001; 95% CI, −0.76 to 0.75, p = 0.99) in patients with diabetic foot ulcers. The examined data revealed that hyperbaric oxygen treatment had a significantly higher healed ulcer, adverse event, and ulcer area reduction and lower mortality, however, there was no significant difference in amputation and healing time compared to standard treatment in patients with diabetic foot ulcers. Yet, attention should be paid to its values since most of the selected examinations had a low sample size and some of the comparisons had a low number of selected studies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Imam,

Almutairi,

Alhajri

et al. 2023

International Wound Journal

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“…In comparison, negative-pressure wound therapy has been shown to improve wound healing when compared to advanced moist wound therapy. 7,16,18,31 Current evidence does not support the use of antibiotic therapy in the management of noninfected ulcers (Figures 3 and Figure 5A).…”

Section: Advanced Healing Modalitiesmentioning

confidence: 99%

“…45 Although bone cultures are ideal, deep soft tissue cultures may be beneficial in identifying the offending organism in osteomyelitis. 18,34 After proper evaluation, infections should be classified using the IDSA system to assist in selecting the best treatment and to improve communication among providers.…”

Section: Evaluation: Microbiologymentioning

confidence: 99%

Republication of “The Evaluation and Treatment of Diabetic Foot Ulcers and Diabetic Foot Infections”

Core

Ahn

Lewis

et al. 2023

Foot & Ankle Orthopaedics

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Diabetic foot ulcers and infections are common complications of diabetic foot disease. Additionally, these complications are a common cause of morbidity and impose a substantial burden to the patient and society. It is imperative to understand the major contributing factors, namely, diabetic neuropathy, peripheral arterial disease, and immune system dysfunction in order to guide treatment. Management of diabetic foot disease begins with a detailed history and thorough physical examination. This examination should focus on the manifestations of diabetic neuropathy and peripheral arterial disease, and, in particular, any evidence of diabetic foot ulcers or infection. Prevention strategies should include a multi-disciplinary approach centered on patient education.

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Mesenchymal stem cell therapy in diabetic foot ulcer: An updated comprehensive review

Hetta,

Elsaghir,

Sijercic

et al. 2024

Health Science Reports

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BackgroundDiabetes has evolved into a worldwide public health issue. One of the most serious complications of diabetes is diabetic foot ulcer (DFU), which frequently creates a significant financial strain on patients and lowers their quality of life. Up until now, there has been no curative therapy for DFU, only symptomatic relief or an interruption in the disease's progression. Recent studies have focused attention on mesenchymal stem cells (MSCs), which provide innovative and potential treatment candidates for several illnesses as they can differentiate into various cell types. They are mostly extracted from the placenta, adipose tissue, umbilical cord (UC), and bone marrow (BM). Regardless of their origin, they show comparable features and small deviations. Our goal is to investigate MSCs' therapeutic effects, application obstacles, and patient benefit strategies for DFU therapy.MethodologyA comprehensive search was conducted using specific keywords relating to DFU, MSCs, and connected topics in the databases of Medline, Scopus, Web of Science, and PubMed. The main focus of the selection criteria was on English‐language literature that explored the relationship between DFU, MSCs, and related factors.Results and DiscussionNumerous studies are being conducted and have demonstrated that MSCs can induce re‐epithelialization and angiogenesis, decrease inflammation, contribute to immunological modulation, and subsequently promote DFU healing, making them a promising approach to treating DFU. This review article provides a general snapshot of DFU (including clinical presentation, risk factors and etiopathogenesis, and conventional treatment) and discusses the clinical progress of MSCs in the management of DFU, taking into consideration the side effects and challenges during the application of MSCs and how to overcome these challenges to achieve maximum benefits.ConclusionThe incorporation of MSCs in the management of DFU highlights their potential as a feasible therapeutic strategy. Establishing a comprehensive understanding of the complex relationship between DFU pathophysiology, MSC therapies, and related obstacles is essential for optimizing therapy outcomes and maximizing patient benefits.

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Response to Comments on Fedorko et al. Hyperbaric Oxygen Therapy Does Not Reduce Indications for Amputation in Patients With Diabetes With Nonhealing Ulcers of the Lower Limb: A Prospective, Double-Blind, Randomized Controlled Clinical Trial. Diabetes Care 2016;39:392–399

Cited by 7 publications

References 7 publications

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

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

Republication of “The Evaluation and Treatment of Diabetic Foot Ulcers and Diabetic Foot Infections”

Mesenchymal stem cell therapy in diabetic foot ulcer: An updated comprehensive review

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