From the Guidelines
Hyperbaric oxygen therapy (HBOT) should be considered as an adjunctive treatment for diabetic foot ulcers, particularly in patients who have failed standard wound care, as it may improve wound healing and reduce the risk of amputation, according to the most recent guidelines 1.
Key Points
- HBOT involves breathing 100% oxygen in a pressurized chamber, which increases oxygen delivery to damaged tissues and promotes healing.
- The evidence for HBOT in diabetic foot ulcers is conflicting, but the most recent guidelines suggest that it may be beneficial in improving wound healing and reducing amputation risk 1.
- A typical HBOT regimen consists of 90-120 minute sessions, conducted once or twice daily, with treatment courses ranging from 10-40 sessions depending on the condition being treated.
- Side effects of HBOT are generally mild and may include ear and sinus pain, temporary nearsightedness, or claustrophobia.
- HBOT should be administered by trained medical professionals in a clinical setting, as improper use can lead to oxygen toxicity or fire hazards.
Considerations
- The decision to use HBOT should be made on a case-by-case basis, taking into account the individual patient's needs and medical history.
- Patients with general frailty and comorbid conditions may need to be excluded from HBOT due to increased risks of adverse events 1.
- The cost-effectiveness of HBOT is still a topic of debate, and further studies are needed to determine its cost-effectiveness in different patient populations 1.
Recommendations
- HBOT should be considered as an adjunctive treatment for diabetic foot ulcers, particularly in patients who have failed standard wound care 1.
- Patients should be assessed for suitability for HBOT, and those with general frailty and comorbid conditions may need to be excluded from treatment 1.
- HBOT should be administered by trained medical professionals in a clinical setting, with careful monitoring of side effects and adverse events 1.
From the Research
Hyperbaric Treatments Overview
- Hyperbaric oxygen therapy (HBOT) is used as a primary or adjunctive therapy for various pathologies, including chronic wounds, carbon monoxide poisoning, decompression illness, and gas embolisms 2.
- HBOT has been utilized for decades in medical disciplines, such as wound healing, and is considered a mainstay of management for life-threatening conditions 2, 3.
Applications of Hyperbaric Oxygen Therapy
- HBOT is used to treat chronic wounds, including diabetic foot ulcers, by promoting ulcer healing and reducing amputation rates 2, 4.
- Hyperbaric oxygen therapy is also used to treat emergency indications, such as arterial gas embolism, decompression sickness, and acute carbon monoxide poisoning 3, 5.
- Elective applications of HBOT include wound healing, with many hyperbaric centers in the US treating elective problems adjunctively 6.
Efficacy and Evidence
- The efficacy of HBOT in treating diabetic foot ulcers is not clear, with limited clinical evidence to support its use 4.
- High-quality studies with rigorous study designs and larger samples are needed to fully understand the benefits and limitations of HBOT in various applications 4.
- The quality of evidence for HBOT is generally low to moderate, with few high-quality studies available to support its use 4.