Factors influencing the outcome of lower-extremity diabetic ulcers treated with hyperbaric oxygen therapy.
Auteur(s)
Fife CE, Buyukcakir C, Otto G, Sheffield P, Love T, Warriner R 3rd.
Jaartal
2007
Tijdschrift
Wound Repair Regen. 2007 May-Jun;15(3):322-31.
Type publicatie
Onderzoek
Onderzoek
Retrospectief cohort
Aantal
1006
Selectiecriteria
patients receiving hyperbaric oxygen therapy (HBO(2)T) for diabetic lower-extremity ulcers
Methode
Five hyperbaric facilities supplied data on 1,006 patients. A sixth clinic served as a validation sample for the regression-based prediction model, and later additional data from Memorial Hermann Hospital were added. The severity of lower-extremity lesions was assessed upon initiation of HBO(2)T using the Modified Wagner scale, and the outcome described as healed, partially healed, not improved, amputated, or died.
Resultaat
Overall, 73.8% of patients improved (granulated or healed). Factors significantly related to outcome included renal failure, pack-year smoking history, transcutaneous oximetry, number of HBO(2)T treatments, and interruption of treatment regimen. Number of treatments per week and treatment pressure (2.0 vs. 2.4 atmospheres absolute) were not significant factors in outcome. Concomitant administration of autologous growth factor gel did not improve outcome. A multiple regression model was fitted to the data that can be used to predict the outcome of diabetic patients undergoing HBO(2)T.
Conclusie
Given the high cost of amputation and rehabilitation, these data suggest that hyperbaric oxygen treatment should be an important adjunctive therapy to heal lower-extremity lesions, especially those with a Wagner grade of 3 or higher.
Externe link
Indicatie
Diabetisch voetulcus
