Duzgun

Hyperbaric oxygen improved healing and reduced amputation rate in diabetic foot ulcers

Clinical bottom line:

1.HBOT improved the chance of healing in diabetic ulcers
2. HBOT also reduced the chance of amputations and significant surgical interventions in these patients.

Citation:Duzgun AP, Satir HZ, Ozozan O, Saylam B, Kulah B, Coskun F. Effect of hyperbaric oxygen therapy on healing of diabetic foot ulcers. J of Foot & Ankle Surgery. 2008;47(6):515-9.


Lead author's name and fax:Arife Polat Duzgun. No email or fax supplied.

Three-part Clinical Question:Does adding Hyperbaric Oxygen Therapy to Standard Treatment in adult diabetics with foot ulcers result in greater healing with less surgical intervention?

Search Terms:Diabetes, diabetic foot ulcers, foot ulcers

The Study:Non-blinded randomised controlled trial with intention-to-treat.

The Study Patients:Adult patients with diabetes and an infected foot wound that had not responded to 'appropriate' local and systemic wound care for 4 weeks.

Control group(N = 50; 50 analysed): Standard treatment of wounds including dressing changes and debridement as clinically dictated.

Experimental group(N = 50; 50 analysed): As above with HBOT at 2-3 ATA for 90 min, twice daily then once daily on alternate days for between 20-30 days

The Evidence:

Outcome

Time to Outcome

Control group

HBOT group

Relative risk reduction

Absolute risk reduction

NNT

Healed with minor bedside debridement

92 weeks

0

0.66

INF

0.66

2

95% CIs:

 

0.53 to 0.79

1 to 2

Graft or Flap required

92 weeks

0

0.08

INF

0.08

13

95% CIs:

 

0.01 to 0.16

6 to 208

Minor amputation

92 weeks

0.48

0.08

83%

0.40

3

95% CIs:

51% to 100%

0.24 to 0.56

2 to 4

Major amputation

92 weeks

0.34

0

INF

0.34

3

95% CIs:

51% to 100%

0.24 to 0.56

2 to 4

 

Comments:

1. Study not blinded and and therefore at some risk of bias.

2. There were more men, obese patients and smokers in the HBO group.

3. No differentiation between neuropathic vs pure ischaemic ulcers.

4. Exact HBOT protocol is unclear and not the same for all patients.

 

Appraised by:Dr Glen Hawkins Hyperbaric Health, Suite 3 Ground Floor, 46-50 Kent Rd, Mascot NSW 2020 Fax: +61282125987; January 2018

Email: glen.hawkins@unsw.edu.au

Kill or Update By:July 2022

 

Sumhorsa.gif

BACK