Hyperbaric oxygen therapy in the healing process of foot ulcers in diabetic type 2 patients marked by interleukin 6, vascular endothelial growth factor, and PEDIS score: A randomized controlled trial study

Abstract

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:

ICAM-1 levels in patients with covid-19 with diabetic foot ulcers: A prospective study in southeast asia

“…no. ECM335, Burlington, Massachusetts, USA) [ 9 , 19 , 20 ]. All patients were then treated with a protocol for DFUs that included debridement.…”

“…The prevalence of diabetes mellitus increased from 108 million in 1980 to 422 million in 2014 according to the WHO. In Southeast Asia, the prevalence was 71.4 million in 2011 and this is predicted to increase to 120 million people in 2030 [ 8 , 9 ]. Diabetes mellitus is a syndrome that includes metabolic and vascular aspects in which fasting, postprandial, or random blood glucose levels increase.…”

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“…This study is a secondary data analysis of information previously collected in two separate studies, each concerning the effects of HBOT on diabetic foot ulcers [ 21 ] and crush injury fractures [ 12 ]. This research is structured to analyze the HBOT approach from a new perspective, specifically, the development of an algorithm to determine therapy based on the algorithm's predictive ability using a decision tree analysis.…”

“…HBOT as an adjuvant or complementary therapy is widely applied today [ 10 , 11 , [17] , [18] , [19] ]. Several studies demonstrate the effectiveness of HBOT in wound healing and inflammation [ 4 , 12 , 20 , 21 ].…”

The Strong Correlation Between ADAM33 Expression and Airway Inflammation in Chronic Obstructive Pulmonary Disease and Candidate for Biomarker and Treatment of COPD

“…After incubation, the reaction was stopped by adding 50 µl of Stop Solution containing H 2 SO 4 to each well following which levels were measured within 30 minutes using the ELISA Reader 270 (Biomerieux, France) at a wavelength of 450 nm. The target soluble protein concentration was represented in ng/ml [7,12,13,14].…”