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Hyperbaric Oxygen for Ischemic Diabetic Foot Ulcers?

Discussion in 'Diabetic Foot & Wound Management' started by Dieter Fellner, Feb 18, 2018.

  1. Dieter Fellner

    Dieter Fellner Well-Known Member


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    https://www.jwatch.org/na45884/2018/01/23/hyperbaric-oxygen-ischemic-diabetic-foot-ulcers

    Allan S. Brett, MD reviewing Santema KTB et al. Diabetes Care 2018 Jan .

    This intervention did not improve outcomes in a randomized trial.

    Evidence about the effectiveness of hyperbaric oxygen therapy (HBOT) in patients with chronic ischemic leg ulcers is conflicting. In this trial from the Netherlands, 120 diabetic patients with ischemic foot ulcers were randomized to either standard care or standard care plus HBOT. All patients had evidence of limb ischemia (according to distal extremity blood pressures or low transcutaneous oxygen pressures), and patients who were candidates for revascularization underwent such procedures prior to starting HBOT. HBOT consisted of five 90-minute sessions weekly until healed (maximum sessions, 40).
    In intent-to-treat analyses at 12 months, the two groups did not differ significantly in incidences of complete wound healing, major amputation, or all-cause death. One third of patients in the HBOT group did not complete treatment. In a per-protocol analysis (in which only patients who received full HBOT courses were included in the HBOT group), the proportion of patients who underwent major amputation was significantly lower with HBOT than without it (5% vs. 22%).
     
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