Introduction: Diabetic foot ulcers (DFU) is a major social issue in terms of treatment cost. DFU has a high risk of infection with morbidity and an increased risk of lower-extremity amputations. Currently, there are no satisfactory treatments for DFU. This motivates a search for methods that can stimulate the acceleration of wound healing; one of these methods is the use of hyperbaric oxygen therapy (HBOT). This study attempts to prove the ability of HBOT to accelerate the healing process of DFU by increasing levels of both serum Interleukin 6 (IL-6) and Vascular Endothelial Growth Factor (VEFG), assessed by the perfusion, extent, depth, infection and sensation (PEDIS) score. Methods: Twenty DFU patients were divided into two groups. The control group underwent a holistic DFU treatment without HBOT and was tested twice for serum IL-6 and VEGF levels, 1 day apart. The HBOT group underwent a holistic DFU treatment with HBOT and was also tested twice for serum IL-6 and VEGF levels: one day before HBOT and 2 h after the first day of HBOT. Results: The changes in serum IL-6 and VEGF levels were greater in patients with HBOT than in control patients (p = 0.025 and p = 0.004). As for PEDIS score assessment, the HBOT group had significantly lower PEDIS scores than the control group (p < 0.001). Conclusion: HBOT can help accelerate the wound healing process, which was proven by increased serum IL-6 and VEGF levels and a lower PEDIS score. Highlights:

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Introduction: Limb injury is a major health concern that imposes a direct danger to both life and limb viability. At Kandou Hospital Manado, hyperbaric oxygen (HBO) therapy has been performed as an adjunctive treatment for crush injury although no study has yet directly compared outcomes of HBO versus conventional therapy. Documentation of the association between HBO therapy and the healing process of crush injury is necessary to reduce the gaps in the literature and to establish an evidence-based clinical use of HBO therapy. Methods: In this study, we assessed the changes in the vascular endothelial growth factor (VEGF) serum levels and VEGF mRNA expression as biomarkers of wound healing using ELISA and qRT-PC at four different measurement times: at baseline, after receiving initial treatment (debridement and limb-salvage surgeries), 2 h after the first session HBOT, and after a full 10 HBOT sessions. A randomized controlled trial (RCT) was used to enroll patients subjected to crush injury who were admitted to the Surgical Emergency Department (ER) of Kandou Hospital Manado, Indonesia. Results: VEGF serum levels increased significantly in patients suffering from crush injury who received HBO therapy versus the control group. The increased VEGF serum is expected to result in an acceleration time of wound healing and a reduction in amputation rate. Conclusion: There was a significant difference between crush injury patients who received conservative therapy versus those receiving HBO therapies; thus, there was an increased likelihood of an accelerated wound healing and a reduction in the risk of amputation. Highlights