Hyperbaric oxygenation accelerates the healing rate of nonischemic chronic diabetic foot ulcers: a prospective randomized study
Auteur(s)
Kessler L, Bilbault P, Ortéga F, Grasso C, Passemard R, Stephan D, Pinget M, Schneider F.
Jaartal
2003
Tijdschrift
Diabetes Care. 2003 Aug;26(8):2378-82.
Type publicatie
Onderzoek
Onderzoek
prospective randomized study
Aantal
28
Selectiecriteria
patients with diabetes, demonstrating chronic Wagner grades I-III foot ulcers without clinical symptoms of arteriopathy, who did not improve over 3 months of full standard treatment.
Methode
HBO was applied twice a day, 5 days a week for 2 weeks; each session lasted 90 min at 2.5 ATA. The main parameter studied was the size of the foot ulcer measured on tracing graphs with a computer. It was evaluated before HBO and at day 15 and 30 after the baseline.
Resultaat
All the patients demonstrated signs of neuropathy. HBO was well tolerated in all but one patient (barotraumatic otitis). The transcutaneous oxygen pressure (TcPO(2)) measured on the dorsum of the feet of the patients was 45.6 +/- 18.1 mmHg (room air). During HBO, the TcPO(2) measured around the ulcer increased significantly from 21.9 +/- 12.1 to 454.2 +/- 128.1 mmHg (P < 0.001). At day 15 (i.e., after completion of HBO), the size of ulcers decreased significantly in the HBO group (41.8 +/- 25.5 vs. 21.7 +/- 16.9% in the control group [P = 0.037]). Such a difference could no longer be observed at day 30 (48.1 +/- 30.3 vs. 41.7 +/- 27.3%). Four weeks later, complete healing was observed in two patients having undergone HBO and none in the control group.
Conclusie
In addition to standard multidisciplinary management, HBO doubles the mean healing rate of nonischemic chronic foot ulcers in selected diabetic patients. The time dependence of the effect of HBO warrants further investigations.
Externe link
Indicatie
Diabetisch voetulcus
