A comparison of standard wound care vs. standard wound care with adjunct hyperbaric oxygen therapy in diabetic arterial ulceration

Abstract

Background: As the incidence of diabetes increases so does the prevalence of diabetic arterial ulcerations, which if not treated promptly, may lead to loss of morbidity posing a great burden on the patient’s quality of life and the health care system. Diverse treatment modalities and protocols for arterial ulcerations are available, however further studies should be conducted to compare and evaluate the clinical efficacy of such treatments. Aim: The aim of this study was to compare Standard Wound Care versus Standard Wound Care with Adjunct Hyperbaric Oxygen Therapy in the treatment of diabetic arterial foot ulceration. Research Design and Method: A quasi-experimental, matched-control clinical trial was conducted at the Tissue Viability Unit and at the Hyperbaric Oxygen Therapy Unit. Twenty-six participants living with Type 2 Diabetes and presenting with a newly diagnosed arterial foot ulcer were recruited. Subjects were divided into 2 groups. Group A underwent Standard Wound Care with adjunct Hyperbaric Oxygen Therapy and Group B underwent Standard Wound Care only. Following application of treatment, participants were reviewed every week for a period of four weeks and their ulcers were measured for their surface area and depth to assess any change in wound size. Results: Both Standard Wound Care with adjunct Hyperbaric Oxygen Therapy and Standard Wound Care only were effective in reducing the surface area and depth of ulcer (p=0.00). Nonetheless, SWC with adjunctive HBOT was 3.57 times better in reducing the surface area (p=0.000) of the ulcer and 4.61 times in reducing the depth of the ulcer (p=0.000) when compared to SWC only. Conclusion: Standard Wound Care with adjunctive Hyperbaric Oxygen Therapy, could be considered as a more practical and effective modality when treating diabetic arterial foot ulcerations, owing to its advantages in reducing the surface area and depth of ulcers in comparison to Standard Wound Care only. Provision of optimal wound care, would promote wound healing, bringing about significant reductions in the number of amputations which will eventually improve the patients’ quality of life and reduce both morbidity and mortality in this high-risk population.