Hyperbaric Oxygen Therapy: Evidence Based Role in Diabetic Foot

Abstract

With the increasing prevalence of diabetes in the community, morbidity and mortality as a result of diabetic feet has been increasing. Foot complications are one of the most serious and yet preventable complications of diabetes mellitus having an economic impact to the individual and adding the burden to the already inadequate healthcare resources. There are more than 170 million diabetics worldwide of which about 30 million are in India and this number is expected to double by year 2030. Of these about 15% will develop an open foot ulcer. Twnty percent of these ulcers may eventually lead to an amputation. More than 80% of these lesions can be easily prevented or managed with timely and optimum intervention with a combined team approach including Hyperbaric Oxygen (HBO) therapy. Recent research in the role of Hyperbaric Oxygen Therapy (HBOT) in diabetic wounds has confirmed its role in promoting oxygenation, enhance immune mechanisms, neovascular formation, fibroblast proliferation and other beneficial actions. It is now accepted as a useful adjunctive treatment in a select group of diabetic patients with severe or limb threatening wounds. This article discusses the physiological basis, role and place of HBOT in the modern multidisciplinary approach to the treatment of diabetic foot wounds.