Hyperbaric Oxygen for the Treatment of Diabetic Foot Ulcers: A Systematic Review

Stoekenbroek, Robert M.; Santema, T.B.; Legemate, Dink A.; Ubbink, Dirk T.; Brink, A. van den; Koelemay, M.J.W.

doi:10.1016/j.ejvs.2014.03.005

Cited by 132 publications

(60 citation statements)

References 32 publications

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“…HBOT can promote healing of ischemic viable tissues via different mechanisms including oxygenation as long as there is no necrosis 36,37. The non-viable, necrotic tissue cannot be oxygenated even with HBOT and therefore it is being surgically removed.…”

Section: Discussionmentioning

confidence: 99%

Reversibility of retinal ischemia due to central retinal artery occlusion by hyperbaric oxygen

Hadanny¹,

Maliar²,

Fishlev³

et al. 2016

OPTH

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PurposeIschemic retinal damage can be reversed by hyperbaric oxygen therapy (HBOT) as long as irreversible infarction damage has not developed. However, the time window till irreversible damage develops is still unknown. The study aim was to evaluate the effect of HBOT and determine possible markers for irreversible retinal damage.Materials and methodsRetrospective analysis of 225 patients treated with HBOT for central retinal artery occlusion (CRAO) in 1999–2015. One hundred and twenty-eight patients fulfilled inclusion/exclusion criteria: age >18 years, symptoms <20 hours, and best-corrected visual acuity (BCVA) <0.5 logMAR.ResultsTime delay from symptoms to treatment was 7.8±3.8 hours. The BCVA was significantly improved after HBOT, from 2.14±0.50 to 1.61±0.78 (P<0.0001). The proportion of patients with clinically meaningful visual improvement was significantly higher in patients without cherry-red spot (CRS) compared to patients with CRS at presentation (86.0% vs 57.6%, P<0.0001). The percentage of patients with final BCVA better than 1.0 was also significantly higher in patients without CRS vs patients with CRS at presentation (61.0% vs 7.1%, P<0.0001). There was no correlation between CRS and the time from symptoms. HBOT was found to be safe, and only 5.5% of patients had minor, reversible, adverse events.ConclusionHBOT is an effective treatment for non-arteritic CRAO as long as CRS has not formed. The fundus findings, rather than the time delay, should be used as a marker for irreversible damage.

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Section: Discussionmentioning

confidence: 99%

Reversibility of retinal ischemia due to central retinal artery occlusion by hyperbaric oxygen

Hadanny¹,

Maliar²,

Fishlev³

et al. 2016

OPTH

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“…The treatment has been shown to improve tissue hypoxia, vessel perfusion, reduce inflammation and edema, and increase angiogenesis [ 106 ]. Numerous studies in patients with DFUs have shown that patients undergoing HBOT show increased healing rates and reduced risk of a major limb amputation [ 107 , 108 ]. Unfortunately, HBOT is cost-prohibitive to the average patient, and while it has an over 20-year track record in the clinic, is still not a complete answer for treating non-healing diabetic foot wounds.…”

Section: Current Therapies To Ameliorate Diabetic Wound Healingmentioning

confidence: 99%

Diabetes and Wound Angiogenesis

Okonkwo

DiPietro

2017

IJMS

688

494

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Diabetes Mellitus Type II (DM2) is a growing international health concern with no end in sight. Complications of DM2 involve a myriad of comorbidities including the serious complications of poor wound healing, chronic ulceration, and resultant limb amputation. In skin wound healing, which has definite, orderly phases, diabetes leads to improper function at all stages. While the etiology of chronic, non-healing diabetic wounds is multi-faceted, the progression to a non-healing phenotype is closely linked to poor vascular networks. This review focuses on diabetic wound healing, paying special attention to the aberrations that have been described in the proliferative, remodeling, and maturation phases of wound angiogenesis. Additionally, this review considers therapeutics that may offer promise to better wound healing outcomes.

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“…The increase of oxygen levels in the hypoxic wound is essential for the cells involved in the healing process (neutrophils, fibroblasts, macrophages) to carry out their specific repair functions [ 6 ]. Linked to this observation, HBOT has been evidenced to diminish the number of major lower limb amputations among diabetic people [ 7 , 8 ]. The increased oxygen availability during HBOT is an essential mediating factor associated to wound collagen deposition, cross-linking and neovascularization [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Antioxidant Response of Chronic Wounds to Hyperbaric Oxygen Therapy

et al. 2016

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We analyzed the effects of the clinical hyperbaric oxygen therapy (HBOT) on the plasma antioxidant response and levels of endothelin-1, Interleukine-6 (IL-6) and vascular endothelial growth factor (VEGF) in patients with chronic wounds (20.2±10.0 months without healing). They received 20 HBOT sessions (five sessions/week), and blood samples were obtained at sessions 1, 5 and 20 before and 2 hours after the HBOT. An additional blood sample was collected 1 month after wound recovery. Serum creatine kinase activity decreased progressively in accordance with the wound healing. Plasma catalase activity significantly increased after the first and fifth sessions of HBOT. Plasma myeloperoxidase activity reported significantly lower values after sessions. Plasma VEGF and IL-6 increased after sessions. Endothelin-1 levels were progressively decreasing during the HBOT, being significant at the session 20. Plasma malondialdehyde concentration was significantly reduced at the last session. Both creatine kinase activity and malondialdehyde levels were maintained lower 1 month after wound recovery respect to initial values. In conclusion, HBOT enhanced the plasma antioxidant defenses and may contribute to activate the healing resolution, angiogenesis and vascular tone regulation by increasing the VEGF and IL-6 release and the endothelin-1 decrease, which may be significant factors in stimulating wound healing.

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Hyperbaric Oxygen for the Treatment of Diabetic Foot Ulcers: A Systematic Review

Cited by 132 publications

References 32 publications

Reversibility of retinal ischemia due to central retinal artery occlusion by hyperbaric oxygen

Reversibility of retinal ischemia due to central retinal artery occlusion by hyperbaric oxygen

Diabetes and Wound Angiogenesis

Antioxidant Response of Chronic Wounds to Hyperbaric Oxygen Therapy

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