Adjunctive Hyperbaric Oxygen Therapy for Healing of Chronic Diabetic Foot Ulcers

Chen, Chen-Yu; Wu, Re‐Wen; Hsu, Mei‐Chi; Hsieh, Ching‐Chuan; Chou, Man-Chun

doi:10.1097/won.0000000000000374

Cited by 70 publications

(112 citation statements)

References 39 publications

Supporting

Mentioning

100

Contrasting

Unclassified

Order By: Relevance

“…Chen et al . also reported a significantly ( P =0.010) lower amputation rate in participants allocated to HBOT (5%) compared to controls (11%), although it was not possible to replicate their statistical findings. In the other four trials it was reported that the requirement for major amputation was not significantly different between groups .…”

Section: Resultsmentioning

confidence: 92%

“…Also one further trial did not clarify whether minor or major amputations were reported . For the purpose of the present meta‐analysis it was assumed the data represented major amputations, although it was not possible to confirm this despite contacting the authors . Finally, the funnel plot for the primary outcome suggested the possibility of publication bias owing to the asymmetrical distribution of data points.…”

Section: Discussionmentioning

confidence: 89%

“…The total number of participants randomized to HBOT or control groups in different trials varied from 18 to 120 in the different trials (Table ). The entry criteria and outcomes varied for the different trials, as shown in Table , although all trials reported the proportion of participants with complete ulcer healing as one of the outcomes . Minor and major amputation were more variably reported, with this information only reported in six of the trials (Table ) .…”

Section: Resultsmentioning

confidence: 99%

“…Key elements of trial design, such as blinding of study personnel and outcome assessors, a justifiable sample size calculation and a clear primary outcome measure were not reported for this trial . Thirdly, many of the other included trials had a number of methodological weaknesses, such as absence of a reported blinded outcome assessment in five of the trials , and lack of a sample size calculation in five trials . Fourthly, all the included trials were small (the largest included 120 participants) and, while the meta‐analysis enabled a total of 585 people to be included for the primary outcome of ulcer healing, the most important outcome of major amputation included a smaller number of participants.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Systematic review and meta‐analysis of clinical trials examining the effect of hyperbaric oxygen therapy in people with diabetes‐related lower limb ulcers

Golledge

Singh

2019

Diabet. Med.

View full text Add to dashboard Cite

Aim To examine the efficacy of hyperbaric oxygen therapy in healing diabetes‐related lower limb ulcers through a meta‐analysis of randomized clinical trials. Methods A literature search was conducted to identify appropriate clinical trials. Inclusion required randomized study design and reporting of the proportion of diabetes‐related lower limb ulcers that healed. A meta‐analysis was performed to examine the effect of hyperbaric oxygen therapy on ulcer healing. The secondary outcomes were minor and major amputations. Results Nine randomized trials involving 585 participants were included. People allocated to hyperbaric oxygen therapy were more likely to have complete ulcer healing (relative risk 1.95, 95% CI 1.51–2.52; P<0.001), and less likely to require major (relative risk 0.54, 95% CI 0.36–0.81; P=0.003) or minor (relative risk 0.68, 95% CI 0.48–0.98; P=0.040) amputations than control groups. Sensitivity analyses suggested the findings were dependent on the inclusion of one trial. Adverse events included ear barotrauma and a seizure. Many of the trials were noted to have methodological weaknesses including absence of blinding of outcome assessors, lack of a justifiable sample size calculation and limited follow‐up. Conclusions This meta‐analysis suggests hyperbaric oxygen therapy improves the healing of diabetes‐related lower limb ulcers and reduces the requirement for amputation. Confidence in these results is limited by significant design weaknesses of previous trials and inconsistent findings. A more rigorous assessment of the efficacy of hyperbaric the efficacy of hyperbaric oxygen therapy is needed.

show abstract

Section: Resultsmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Systematic review and meta‐analysis of clinical trials examining the effect of hyperbaric oxygen therapy in people with diabetes‐related lower limb ulcers

Golledge

Singh

2019

Diabet. Med.

View full text Add to dashboard Cite

show abstract

“…A limitation of this review is the small size and number of RCTs and nonrandomized studies that were available for inclusion. Unfortunately, most authors did not respond to our request for additional data, which also led to the exclusion of two major RCTs . Nevertheless, this review currently represents the best available evidence for this specific subgroup of patients.…”

Section: Discussionmentioning

confidence: 99%

Hyperbaric oxygen therapy for nonischemic diabetic ulcers: A systematic review

Lalieu

Brouwer

Ubbink

et al. 2019

Wound Repair Regeneration

View full text Add to dashboard Cite

Diabetic foot ulcers are a common complication of diabetes, which affects 25% of patients and may ultimately lead to amputation of affected limbs. Research suggests hyperbaric oxygen therapy improves healing of these ulcers. However, this has not been reflected in previous reviews, possibly because they did not differentiate between patients with and without peripheral arterial occlusive disease. Therefore, we performed a systematic review of published literature in the MEDLINE, Embase, and Cochrane CENTRAL databases on nonischemic diabetic foot ulcers with outcome measures including complete ulcer healing, amputation rate (major and minor), and mortality. Seven studies were included, of which two were randomized clinical trials. Two studies found no difference in major amputation rate, whereas one large retrospective study found 2% more major amputations in the hyperbaric oxygen group. However, this study did not correct for baseline differences. Two studies showed no significant difference in minor amputation rate. Five studies reporting on complete wound healing showed no significant differences. In conclusion, the current evidence suggests that hyperbaric oxygen therapy does not accelerate wound healing and does not prevent major or minor amputations in patients with a diabetic foot ulcer without peripheral arterial occlusive disease. Based on the available evidence, routine clinical use of this therapy cannot be recommended. However, the available research for this specific subgroup of patients is scarce, and physicians should counsel patients on expected risks and benefits. Additional research, focusing especially on patient selection criteria, is needed to better identify patients that might profit from this therapy modality.

show abstract

Triboelectric Nanogenerators for Self‐Powered Wound Healing

Xiao

Nashalian

Libanori

et al. 2021

Adv Healthcare Materials

View full text Add to dashboard Cite

Wound healing, one of the most complex processes in the human body, involves the spatial and temporal synchronization of a variety of cell types with distinct roles. Slow or nonhealing skin wounds have potentially life-threatening consequences, ranging from infection to scar, clot, and hemorrhage. Recently, the advent of triboelectric nanogenerators (TENGs) has brought about a plethora of self-powered wound healing opportunities, owing to their pertinent features, including wide range choices of constitutive biocompatible materials, simple fabrication, portable size, high output power, and low cost. Herein, a comprehensive review of TENGs as an emerging biotechnology for wound healing applications is presented and covered from three unique aspects: electrical stimulation, antibacterial activity, and drug delivery. To provide a broader context of TENGs applicable to wound healing applications, state-of-the-art designs are presented and discussed in each section. Although some challenges remain, TENGs are proving to be a promising platform for human-centric therapeutics in the era of Internet of Things. Consequently, TENGs for wound healing are expected to provide a new solution in wound management and play an essential role in the future of point-of-care interventions.

show abstract

Adjunctive Hyperbaric Oxygen Therapy for Healing of Chronic Diabetic Foot Ulcers

Abstract: Adjunctive HBOT improved wound healing in persons with DFU. Therapy also reduced the risk of amputation of the affected limb. We assert that at least 20 HBOT sessions are required to be effective.

Cited by 70 publications

References 39 publications

Systematic review and meta‐analysis of clinical trials examining the effect of hyperbaric oxygen therapy in people with diabetes‐related lower limb ulcers

Systematic review and meta‐analysis of clinical trials examining the effect of hyperbaric oxygen therapy in people with diabetes‐related lower limb ulcers

Hyperbaric oxygen therapy for nonischemic diabetic ulcers: A systematic review

Triboelectric Nanogenerators for Self‐Powered Wound Healing

Contact Info

Product

Resources

About