Article

The role of hyperbaric oxygen therapy in the treatment of diabetic foot ulcers and refractory osteomyelitis

Medical College of Pennsylvania, Philadelphia.
Clinics in Podiatric Medicine and Surgery (Impact Factor: 0.56). 08/1990; 7(3):483-92.
Source: PubMed

ABSTRACT

The use of hyperbaric oxygen therapy in the care of the diabetic patient with nonhealing ulcers, refractory osteomyelitis, or both of the lower extremity can be a valuable adjunct in their overall treatment. Adequate tissue oxygenation to promote wound healing and stimulate cellular defenses can be achieved in a hyperbaric environment. Several clinical studies have supported its use in select patients.

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    • "The technique may be implemented in a walk-in multiplace chamber compressed to depth with air while the person breathes 100% oxygen via head tent, face mask, or endotracheal tube. Multiplace chambers accommodate up to six patients at a time; each patient is given an individual breathing source.13 Alternatively the patient may be treated in one person monoplace chamber pressurized to depth with oxygen. "
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    ABSTRACT: THIS STUDY AIMS TO COMPARE THE EFFICACY OF ANTISEPTIC DRESSINGS, HYPERBARIC OXYGEN THERAPY, AND RECOMBINANT HUMAN PLATELET DERIVED GROWTH FACTOR (RHPDGF) FOR TWO REASONS: i) to reduce the incidence of lower limb amputations in diabetic foot ulcer; ii) to limit the duration of stay in the hospital. A prospective randomized trial was conducted on 60 patients with stage III and IV diabetic foot ulcers (International Association of Enterostomal Therapy classification) and patients were divided randomly in three different therapy groups - antiseptics, hyperbaric oxygen therapy, recombinant platelet derived growth factor, with 20 patients in each group. Patients were managed initially on inpatient and then on outpatient basis till the ulcer healed completely. Results among three groups were compared using unpaired T test and the level of significance was set at P<0.05 using ANOVA. This study compares the efficacy of hyperbaric oxygen therapy, antiseptic dressings, and rhPDGF in grade III and IV diabetic foot ulcers. P value (0.0348) was significant for complete wound contraction while p value healing time (0.6534) and ulcer size (0.0593) in the groups was not significant. PDGF is safe, effective and easy to apply. Results are comparable with hyperbaric oxygen (HBO) therapy and cost of treatment is lower than other therapies. Diabetic foot ulcer management requires multidisciplinary and aggressive approach. PDGF should be recommended for all grade III and IV diabetic foot ulcer at least 8 weeks old. HBO is equally good an option but has limitations and side effects.
    Full-text · Article · Jan 2013
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    ABSTRACT: Hyperbaric oxygenation (HBO, the intermittent inhalation of pure oxygen with partial pressures higher than normal atmospheric pressure at sea level, nowadays preferably performed in multiplace chambers by breathing pure oxygen through a face mask) can be used to improve healing of problem wounds, like chronic skin ulcers, necrotizing infections, thermal burns, soft tissue radionecrosis and skin grafts (reviews: Fischer et al., 1988; Jain, 1990; Buslau and Hoffmann, 1992).
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    ABSTRACT: Perineal involvement in Crohn's disease is a common and distressing condition, often refractory to medical or surgical treatments. Recent reports suggest the efficacy of hyperbaric oxygenation (HBO) in the healing of perineal lesions. We evaluated HBO in severe patients with perineal Crohn's disease. Ten consecutive patients (8 women, 2 men; mean age, 30 years) were studied. There were four superficial fissures, four cavitating ulcers, six low or superficial fistulas, two high fistulas, and one irreversible anal stenosis. All patients had received one or more medical treatments without healing the perineal lesions, and all had had previous surgery for perineal lesions. Two patients discontinued HBO after a few sessions and did not complete treatment. Eight patients completed at least 30 HBO sessions and were evaluable. At the end of the procedure, six of eight patients treated were healed, three completely and three partially. All patients who healed completely received HBO as an additional treatment to local perineal surgery. HBO might be useful as a last resort treatment of chronic perineal Crohn's disease, resistant to other treatments or as a complement to surgery.
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