Hyperbaric oxygenation improved transcutaneous oximetry and other vascular parameters in diabetic feet

Clinical Bottom Line: 1. No clinical results given 2. Transcutanoeus oxygen readings improved over a course of HBOT

Appraised by: Mike Bennett, Diving and Hyperbaric Medicine, Prince of Wales Hospital, Sydney; Monday, 13 August 2001

Clinical Scenario: An insulin dependent diabetic with a lesion on the foot presented for hyperbaric therapy.

Three-part Question: For patients with diabetic foot ulcers, does the additional administration of hyperbaric oxygen, compared to a standard care regime alone, result in any improvement in clinical healing or interim indicators of improved vascular state? Search Terms: Diabetes mellitus, chronic ulcers

The Study: ?Blinded randomised controlled trial, intention-to-treat unknown. Known diabetics with Wagner Grade 0 to 2 lesions of the feet. Control group (N = 12; 12 analysed): Treated for diabetic feet, details unknown. Experimental group (N = 17; 17 analysed): Same treatment as controls but with addition of HBO, dose unknown.

The Evidence:

Non-Event Outcomes Time to outcome Control group Hyperbaric group P-value

Transcutaneous oximetry 30 treatments 36 +-21 58 +-21 <0.01 (mmHg)

HbA1C (%) 30 treatments 9.3 +-4.3 6.6 +-1.7 <0.01

Laser-doppler perfusion (flux) 30 treatments 26 +-4 36 +-7 <0.01

Ankle Brachial Index 30 treatments NS

Comments: 1. No clinical outcome information 2. Abstract only, few details

Expiry date: July 2021

References: 1. Lin TF, Chen SB, Niu KC. The vascular effects of hyperbaric oxygen therapy in treatment of early diabetic foot. Undersea and Hyperbaric Medicine 2001; 28 (Suppl):67.