Hyperbaric oxygen therapy facilitates healing of chronic foot ulcers in patients with diabetes.
OBJECTIVE
Chronic diabetic foot ulcers are a source of major concern for both patients and health care systems. The aim of this study was to evaluate the effect of hyperbaric oxygen therapy (HBOT) in the management of chronic diabetic foot ulcers.


METHODS
The Hyperbaric Oxygen Therapy in Diabetics with Chronic Foot Ulcers (HODFU) study was a randomized, single-center, double-blinded, placebo-controlled clinical trial. The outcomes for the group receiving HBOT were compared with those of the group receiving treatment with hyperbaric air. Treatments were given in a multi-place hyperbaric chamber for 85-min daily (session duration 95 min), five days a week for eight weeks (40 treatment sessions). The study was performed in an ambulatory setting.


RESULTS
Ninety-four patients with Wagner grade 2, 3, or 4 ulcers, which had been present for >3 months, were studied. In the intention-to-treat analysis, complete healing of the index ulcer was achieved in 37 patients at 1-year of follow-up: 25/48 (52%) in the HBOT group and 12/42 (29%) in the placebo group (P = 0.03). In a sub-analysis of those patients completing >35 HBOT sessions, healing of the index ulcer occurred in 23/38 (61%) in the HBOT group and 10/37 (27%) in the placebo group (P = 0.009). The frequency of adverse events was low.


CONCLUSIONS
The HODFU study showed that adjunctive treatment with HBOT facilitates healing of chronic foot ulcers in selected patients with diabetes.
Löndahl
Magnus
M
Institution for Clinical Sciences in Lund, Lund University, Lund, Sweden. magnus.londahl@med.lu.se
Katzman
Per
P
Nilsson
Anders
A
Hammarlund
Christer
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000388:Air; D000671:Amputation, Surgical; D002908:Chronic Disease; D017719:Diabetic Foot / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010919:Placebos; D016896:Treatment Outcome; D014945:Wound Healing
D010919:Placebos