EVALUATION OF HYPERBARIC-OXYGEN FOR DIABETIC WOUNDS - A PROSPECTIVE-STUDY

The purpose of this study was to prospectively evaluate the effect of hyperbaric oxygen (HBO2) on the healing of diabetic lower extremity wo unds. Ten consecutive insulin-dependent diabetic patients with chronic lower extremity wounds were referred for HBO2 treatment. The control group consisted of five patients, two claustrophobic and three rural. The latter refused HBO2 treatments because of logistic reasons. Five p atients underwent 30 HBO2 treatments in the problem wound protocol (10 0% oxygen, 2 atm abs, 2 h/day, 5 days/wk). All patients were evaluated with transcutaneous oxygen measurements and had an initial surgical d ebridement of the wound. Weekly tracings of the wound surface area wer e made by a nurse or resident who was blinded to the group assignment. At the end of 7 wk, the mean wound area expressed as a percentage of pretreatment baseline area was compared between groups (analysis of va riance, Duncan's post hoc). No significant differences were noted betw een groups with respect to age, gender, baseline wound area, wound sit e O-2 tension, or presence of osteomyelitis. At the completion of each of the 7-wk treatment periods, a significantly greater reduction in w ound surface area was noted in the HBO2 vs. the control group (P < 0.0 5). HBO2 treatment significantly reduced wound size compared to contro ls in this small, non-randomized prospective study. These results shou ld serve as a basis for larger multicenter prospective, randomized, do uble-blind controlled studies to definitively evaluate the effect of H BO2 on the healing of diabetic foot wounds.