title: Economic outcomes in clinical studies assessing hyperbaric oxygen in the treatment of acute and chronic wounds.
abstract: BACKGROUND
  Hyperbaric oxygen treatment (HBOT) is used to treat acute and chronic wounds. This systematic review was conducted to summarise and evaluate existing evidence on the costs associated with HBOT in the treatment of wounds.
  
  
  METHODS
  We searched multiple electronic databases in March 2015 for cohort studies and randomised clinical trials (RCTs) that reported on the clinical effectiveness and treatment costs of HBOT in the treatment of acute or chronic wounds.
  
  
  RESULTS
  One RCT and three cohort studies reported on economic as well as clinical outcomes. These studies comprised different disorders (ischaemic diabetic foot ulcers, thermal burns, Fournier's gangrene and necrotising soft tissue infections) and employed different clinical and economic outcome measures. Only the RCT had a good methodological quality. Three of the included studies reported that their primary clinical outcomes (wound healing, hospital stay, complications) improved in the HBOT group. The effects of HBOT on costs were variable.
  
  
  CONCLUSIONS
  Currently, there is little direct evidence on the cost-effectiveness of HBOT in the treatment of acute and chronic wounds. Although there is some evidence suggesting effectiveness of HBOT, further studies should include economic outcomes in order to make recommendations on the cost-effectiveness of applying HBOT in wound care.
authors.affiliation: Department of Surgery, room G4-132, Academic Medical Center, P O Box 22660, 1100 DD Amsterdam, The Netherlands, Phone: +31-(0)20-566-3405, Fax: +31-(0)20-566-6569, E-mail: t.b.santema@amc.uva.nl.
authors.forename: Trientje B
authors.initials: TB
authors.lastname: Santema
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Stoekenbroek
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Koen C
authors.initials: KC
authors.lastname: van Steekelenburg
authors.affiliation: Department of Hyperbaric Medicine, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Rob A
authors.initials: RA
authors.lastname: van Hulst
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Mark Jw
authors.initials: MJ
authors.lastname: Koelemay
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Dirk T
authors.initials: DT
authors.lastname: Ubbink
mesh_terms: D000208:Acute Disease; D002056:Burns / Q000628:therapy*; D002908:Chronic Disease; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D017719:Diabetic Foot / Q000628:therapy*; D018934:Fournier Gangrene / Q000628:therapy*; D017722:Hospital Charges; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000191:economics*; D064887:Observational Studies as Topic; D016032:Randomized Controlled Trials as Topic; D018461:Soft Tissue Infections / Q000628:therapy*; D014945:Wound Healing; D014947:Wounds and Injuries / Q000628:therapy
keywords: Hyperbaric oxygen therapy; cost-effectiveness; outcome; systematic review; wounds