title: Evaluation of TCOM/HBOT practice guideline for the treatment of foot burns occurring in diabetic patients.
abstract: OBJECTIVE
  A multidisciplinary team developed an evidence-based guideline for the management of foot burns occurring in diabetic patients that included transcutaneous oxygen measurements (TCOM) and application of hyperbaric oxygen therapy (HBOT) to selected patients. This report represents an evaluation of preliminary TCOM/HBOT data.
  
  
  METHODS
  This is a retrospective review of patients with diabetes mellitus (DM) who were admitted to a single American Burn Association (ABA) verified burn center for the treatment of foot burns. Patients were treated via the guideline if they were over the age of 16, admitted for the initial care of burns involving the feet between 4/01/2012 and 7/22/2013, and had a known or new diagnosis of DM.
  
  
  RESULTS
  Eighteen patients were treated according to the guideline, 14 men and 4 women. Average age was 54 years+14.78. Average BMI was 30.63+6.34. Median burn size was 0.88% TBSA (median partial thickness of 1% and median full thickness of 0.5%). The average HbA1c was 9.08+2.42. Seven patients received pre-operative HBOT, two received post-operative HBOT and three patients healed their wounds with HBOT alone. Average hospital length of stay was 13.39 days+9.94 and was significantly longer for the group receiving HBOT. Admission HbA1c was not a predictor of the need for HBOT.
  
  
  CONCLUSIONS
  While TCOM/HBOT therapy has not been widely applied to the management of diabetic foot burns, the use of an evidence-based guideline incorporating TCOM/HBOT can provide a systematic way to evaluate the patients' microcirculation and ability to heal burns of the foot. The incorporation of TCOM determination and application of HBOT in selected patients with DM and burns of the feet warrant continued study.
authors.affiliation: The Ohio State University Wexner Medical Center, 10th Avenue, N748 Doan Hall, Columbus, OH 43210, United States. Electronic address: Larry.jones@osumc.edu.
authors.forename: Larry M
authors.initials: LM
authors.lastname: Jones
authors.affiliation: The Ohio State University Wexner Medical Center, 10th Avenue, N748 Doan Hall, Columbus, OH 43210, United States.
authors.forename: Christopher
authors.initials: C
authors.lastname: Rubadue
authors.affiliation: The Ohio State University Wexner Medical Center, 10th Avenue, N748 Doan Hall, Columbus, OH 43210, United States.
authors.forename: Nicole V
authors.initials: NV
authors.lastname: Brown
authors.affiliation: The Ohio State University Wexner Medical Center, 10th Avenue, N748 Doan Hall, Columbus, OH 43210, United States.
authors.forename: Sorabh
authors.initials: S
authors.lastname: Khandelwal
authors.affiliation: The Ohio State University Wexner Medical Center, 10th Avenue, N748 Doan Hall, Columbus, OH 43210, United States.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Coffey
mesh_terms: D000328:Adult; D000368:Aged; D001785:Blood Gas Monitoring, Transcutaneous; D001830:Body Surface Area; D002056:Burns / Q000097:blood / Q000150:complications / Q000628:therapy*; D015331:Cohort Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000378:metabolism; D019468:Disease Management; D019317:Evidence-Based Medicine; D005260:Female; D018409:Foot Injuries / Q000097:blood / Q000150:complications / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: Diabetes; Foot burns; Practice guideline