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Hyperbaric oxygen therapy for nonischemic diabetic ulcers: A systematic review
Rutger C Lalieu1, Robin J Brouwer2, Dirk T Ubbink3
1Hyperbaar Geneeskundig Centrum, Rijswijk, The Netherlands.
Summary
Hyperbaric oxygen therapy does not improve healing or prevent amputations for diabetic foot ulcers without arterial disease. Current evidence does not support its routine clinical use in this patient group.
Area of Science:
- Diabetology
- Vascular Surgery
- Wound Healing
Background:
- Diabetic foot ulcers affect 25% of diabetes patients, potentially leading to limb amputation.
- Hyperbaric oxygen therapy (HBOT) is suggested to improve ulcer healing, but evidence is conflicting.
- Previous reviews may lack focus on patients without peripheral arterial occlusive disease (PAOD).
Purpose of the Study:
- To systematically review HBOT's efficacy for non-ischemic diabetic foot ulcers.
- To assess outcomes including complete ulcer healing, amputation rates, and mortality.
- To evaluate HBOT's effectiveness specifically in patients without PAOD.
Main Methods:
- Systematic review of MEDLINE, Embase, and Cochrane CENTRAL databases.
- Inclusion of studies on non-ischemic diabetic foot ulcers.
- Analysis of outcomes: complete healing, major/minor amputations, mortality.
Main Results:
- Seven studies were included (two RCTs).
- No significant differences in complete wound healing rates were found.
- No significant differences in major or minor amputation rates were observed between HBOT and control groups.
Conclusions:
- Current evidence suggests HBOT does not accelerate healing or prevent amputations in diabetic foot ulcers without PAOD.
- Routine clinical use of HBOT for this patient subgroup is not recommended.
- Further research is needed to identify patient selection criteria for potential HBOT benefit.
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