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 1st 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. Conclusion: This study supports the role of HBOT as an adjuvant in healing of diabetic foot ulcers & improving quality of life.
Highlights
Diabetic foot ulcers are a major complication that affects 4-10% of the diabetic population [1]
This double blind prospective comparative & pilot study was conducted in General Surgery Department & Hyperbaric Unit, Armed Forces Hospital Program-Jubail; Saudi Arabia, from the period 2007 till 2013 and comprised 82 diabetic patients, aged 38 to 72 years
Patients were randomized into two groups: Group A assigned to receive Hyperbaric Oxygen Therapy (HBOT) in combination with conventional wound care and group B received conventional wound care only for the treatment of diabetic foot ulcers
Summary
Diabetic foot ulcers are a major complication that affects 4-10% of the diabetic population [1]. The major causes of these ulcers are ischemia/hypoxia, neuropathy, and infection, and they often coexist. Treatment often requires long-term hospital admissions and frequent outpatient visits [2,3]. For foot ulcers, there is still a need for new treatment strategies beside conventional therapy. 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
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