Evaluation of hyperbaric oxygen for diabetic wounds: a prospective study.
The purpose of this study was to prospectively evaluate the effect of hyperbaric oxygen (HBO2) on the healing of diabetic lower extremity wounds. Ten consecutive insulin-dependent diabetic patients with chronic lower extremity wounds were referred for HBO2 treatment. The control group consisted of five patients, two claustrophobic and three rural. The latter refused HBO2 treatments because of logistic reasons. Five patients underwent 30 HBO2 treatments in the problem wound protocol (100% oxygen, 2 atm abs, 2 h/day, 5 days/wk). All patients were evaluated with transcutaneous oxygen measurements and had an initial surgical debridement of the wound. Weekly tracings of the wound surface area were made by a nurse or resident who was blinded to the group assignment. At the end of 7 wk, the mean wound area expressed as a percentage of pretreatment baseline area was compared between groups (analysis of variance, Duncan's post hoc). No significant differences were noted between groups with respect to age, gender, baseline wound area, wound site O2 tension, or presence of osteomyelitis. At the completion of each of the 7-wk treatment periods, a significantly greater reduction in wound surface area was noted in the HBO2 vs. the control group (P < 0.05). HBO2 treatment significantly reduced wound size compared to controls in this small, non-randomized prospective study. These results should serve as a basis for larger multicenter prospective, randomized, double-blind controlled studies to definitively evaluate the effect of HBO2 on the healing of diabetic foot wounds.
Zamboni
W A
WA
Division of Plastic Surgery, University of Nevada School of Medicine, Las Vegas, USA.
Wong
H P
HP
Stephenson
L L
LL
Pfeifer
M A
MA
D002908:Chronic Disease; D003646:Debridement; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D017719:Diabetic Foot / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014945:Wound Healing / Q000502:physiology*