Diabetes Care, Vol 23, Issue 10 1551-1555, Copyright © 2000 by American Diabetes Association

ARTICLES

Systemic hyperbaric oxygen therapy: lower-extremity wound healing and the diabetic foot

RP Wunderlich, EJ Peters and LA Lavery
Diabetex Foot Care Center, San Antonio, Texas 78212, USA. robert@wunderlich.com

OBJECTIVE: To document peer-reviewed medical publications that have reported on hyperbaric oxygen (HBO) therapy as an adjunct to standard lower-extremity wound care, focusing on publications dealing with the diabetic foot. RESEARCH DESIGN AND METHODS: A review of the medical literature was conducted using MEDLINE. Research articles involving HBO treatment and the diabetic foot were critiqued to identify factors that may have been a source of bias. RESULTS: Of the published reports on human studies, seven involved diabetes-related foot pathology. Five of these studies, two of which were randomized, included a control group that did not receive HBO therapy The controlled diabetic foot studies included an average of 28 subjects in the HBO therapy group (range 10-62) and an average of 16.2 subjects in the non-HBO control group (range 5-33). Most of the published reports have several potential sources of bias, including, but not limited to, inadequate evaluation of comorbid conditions relevant to wound healing, small sample size, and poor documentation of wound size or severity. Four of the seven reports involving the diabetic foot were published by a group of researchers at the University of Milan between 1987 and 1996. CONCLUSIONS: Additional randomized placebo-controlled clinical trials in large diabetic populations would further lend credence to the presumption that HBO therapy improves clinical outcomes. Given the relatively high cost of this treatment modality, perhaps a more acute awareness of the medical literature would reduce the economic burden that HBO therapy imposes on care providers that are financially at risk.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				S. Iscoe and J. A. Fisher Hyperoxia-Induced Hypocapnia: An Underappreciated Risk Chest, July 1, 2005; 128(1): 430 - 433. [Full Text] [PDF]

				B. A. Lipsky, A. R. Berendt, H. G. Deery, J. M. Embil, W. S. Joseph, A. W. Karchmer, J. L. LeFrock, D. P. Lew, J. T. Mader, C. Norden, et al. Diagnosis and Treatment of Diabetic Foot Infections J Am Podiatr Med Assoc, March 1, 2005; 95(2): 183 - 210. [Full Text] [PDF]

				W. A. Marston Role of Hyperbaric Oxygen Therapy in lschemic Diabetic Lower Extremity Ulcers: A Double-Blind Randomisedcontrolled Trial Perspectives in Vascular Surgery and Endovascular Therapy, June 1, 2004; 16(2): 141 - 142. [Abstract] [PDF]

				L. Kessler, P. Bilbault, F. Ortega, C. Grasso, R. Passemard, D. Stephan, M. Pinget, and F. Schneider Hyperbaric Oxygenation Accelerates the Healing Rate of Nonischemic Chronic Diabetic Foot Ulcers: A prospective randomized study Diabetes Care, August 1, 2003; 26(8): 2378 - 2382. [Abstract] [Full Text] [PDF]

				F. Khan and D. J. Newton Laser Doppler Imaging in the Investigation of Lower Limb Wounds International Journal of Lower Extremity Wounds, June 1, 2003; 2(2): 74 - 86. [Abstract] [PDF]