Diabetic foot ulcer healing : hyperbaric oxygen therapy vs standard care

Abstract

Background: Diabetic foot ulcers (DFUs) are a worldwide health concern that cause high rates of morbidity and death (Pendsey, 2010). Standard wound care therapy includes vascular assessments, glycaemic management, surgical debridement, unloading, and a variety of dressings (including saline). Adjuvant treatments have been researched for increasing healing rates over the last few decades, including hyperbaric oxygen therapy (HBOT), which attempts to promote a quicker healing process of DFUs. Methods: A research question was formulated using the PICO framework: Is using hyperbaric oxygen therapy (HBOT) effective in the healing of diabetic foot ulcers in adjunctive to standard care? (P: patients with DFUs, I: HBOT, C: standard wound care, O: DFU healing). A comprehensive literature search was conducted using electronic databases and manual searches, with inclusion criteria including peer-reviewed publications in English text, trials including individuals aged 18 years or older, HBOT, and a 3-week follow-up period. Using the RCT CASP tool (2020), 7 RCTs were retrieved and critically rated, with ethical issues considered. Results: Despite methodological difficulties, all key studies indicated a significant positive difference in DFU healing when HBOT was compared to standard wound care. The treatment was shown to be both safe and beneficial, although the authors recommend that more study be done with bigger sample sizes. Implications & Recommendations: Before HBOT can be improved and advanced in Malta's health care system, further study is needed to determine its effectiveness and safety. Further DFU prevention and management education for healthcare students, professionals, and patients is required. Collaboration among stakeholders to promote HBOT locally was highlighted.