Hyperbaric Oxygen Therapy as adjunctive treatment of chronic diabetic foot ulcers

Research output: ThesisDoctoral Thesis (compilation)

Abstract

Chronic diabetic foot ulcers are a source of major concern for both patients and health care systems. Oxygen deficiency plays a major role in the pathogenesis of these ulcers.
Hyperbaric oxygen therapy (HBOT) has been proposed as a medical treatment for diabetic foot ulcers, but the clinical utility has not been established.
Hyperbaric Oxygen in Diabetic patients with chronic Foot Ulcer (HODFU) study is a prospective, randomized, placebo-controlled, double-blinded study, evaluating the effect of HBOT on ulcer healing in diabetic patients with chronic foot ulcers. Ninety four patients were included, representing 74% of all patients fulfilling the medical inclusion criteria during the inclusion period.
Adjunctive HBOT significantly improved foot ulcer healing at 9- and 12-months follow-ups as compared to placebo. Numbers-needed to treat to avert non-healing of a chronic foot ulcer was 3.1. Treatment was well-tolerated and frequencies of adverse events were low.
TcPO2, but not toe-blood pressure or ankle-brachial index, was identified as prognostic marker for ulcer healing after HBOT.
At one-year follow-up HBOT was associated with improved health related
quality of life. Patients perceived HBOT as unproblematic but time-consuming.
Evaluation of these patients cardiac function indicates that a chronic diabetic foot ulcer should be regarded as a marker of cardiac disease. Thus, pharmacological cardiovascular prevention ought to be considered in all patients with a chronic diabetic foot ulcer.
In conclusion, this study supports the concept that adjunctive treatment with HBOT enhances foot ulcer healing in selected patients with diabetes.
Original languageEnglish
QualificationDoctor
Awarding Institution
  • Department of Clinical Sciences, Lund
Supervisors/Advisors
  • Katzman, Per, Supervisor
  • Apelqvist, Jan, Supervisor
Award date2010 Sept 3
Publisher
ISBN (Print)978-91-86443-94-8
Publication statusPublished - 2010

Bibliographical note

Defence details

Date: 2010-09-03
Time: 09:00
Place: Segerfalk salen, BMC, Lund

External reviewer(s)

Name: Gerok-Andersson, Kurt
Title: MD
Affiliation: Department of Medicine, Karolinska Institutet, Stockholm

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Subject classification (UKÄ)

  • Other Clinical Medicine

Free keywords

  • hyperbaric oxygen therapy
  • Diabetes Mellitus
  • foot ulcer
  • HRQL
  • cardiac function

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