Hyperbaric oxygen therapy in the treatment of diabetic foot ulcers--prudent or problematic: a case report.
Hyperbaric oxygen (HBO) therapy is increasingly used in the management of problem wounds, notably diabetic foot ulcers. However, concerns about unnecessary, inappropriate, and prolonged use of this adjunctive treatment exist. A case report of a 52-year-old patient with diabetes mellitus, Charcot foot, and a nonhealing plantar ulcer who had received HBO treatments only illustrates these concerns. He presented with normal pedal pulses, adequate transcutaneous partial oxygen pressure levels, no offloading footwear, and a heavily contaminated ulcer (Pseudomonas spp.). Following a course of oral antibiotics, appropriate topical wound care, and offloading instructions, the wound healed within 3 months. Advanced wound therapy modalities are only indicated for use in patients when accepted standards of wound care, including identification and correction of underlying disorders and comorbidities, have failed. To prevent misuse/overuse of HBO therapy, stand-alone HBO centers should include a multidisciplinary wound care team.
Mutluoglu
Mesut
M
Department of Underwater and Hyperbaric Medicine, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul, Turkey. drmutluoglu@gmail.com
Uzun
Günalp
G
Yildiz
Senol
S
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001177:Arthropathy, Neurogenic / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D017719:Diabetic Foot / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D005465:Fluorocarbon Polymers / Q000627:therapeutic use; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000706:statistics & numerical data; D008875:Middle Aged; D010348:Patient Care Team; D010353:Patient Education as Topic; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011552:Pseudomonas Infections / Q000209:etiology; D012775:Shoes; D017592:Skin Care / Q000379:methods*; D019564:Unnecessary Procedures / Q000706:statistics & numerical data; D014945:Wound Healing; D014946:Wound Infection / Q000209:etiology
D000900:Anti-Bacterial Agents; D005465:Fluorocarbon Polymers; C010946:polytetrafluoroethane