Ma L, Li P, Shi Z, Hou T, Chen X, Du J, et al.
Ostomy/wound management. Date of publication 2013 Mar 1;volume 59(3):18-24.
1. Ostomy Wound Manage. 2013 Mar;59(3):18-24.
A prospective, randomized, controlled study of hyperbaric oxygen therapy: effects
on healing and oxidative stress of ulcer tissue in patients with a diabetic foot
ulcer.
Ma L(1), Li P, Shi Z, Hou T, Chen X, Du J.
Author information:
(1)Department of Plastic Surgery, Subei People's Hospital, Yangzhou University,
Yangzhou, Jiangsu 225001, China.
Although hyperbaric oxygen (HBO) therapy has been reported to help heal chronic
foot ulcers in patients with diabetes mellitus (DM), production of HBO-related
oxidative stress is a concern. To assess the therapeutic effect and oxidative
stress of HBO, a 2-week, prospective, randomized, controlled clinical study was
conducted from January 1, 2010 to January1, 2012 among 36 consecutively admitted
patients with diabetic foot ulcers (DFU). Average patient age was 60.08 ± 5.97
years and average DM duration was 16.4 ± 11.3 years; 86.1% had type 2 DM, and
47.2% had Wagner grade-III foot ulcers. Patients randomized to the control group
(n = 18) received standard care including offloading, wound debridement, and
glucose control. HBO treatment group patients (n = 18) received standard care and
twice-daily HBO sessions for 90 minutes at 2.5 atmospheres absolute (ATA) 5 days
a week for 2 weeks. Transcutaneous oxygen pressure (TcPo2) at the edge of the
ulcer and wound size were measured at baseline and after 7 and 14 days of
treatment. Ulcer tissues were harvested on days 7 and 14 to determine oxidative
stress by measuring malondialdehyde (MDA) and antioxidant enzyme (superoxide
dismutase [SOD], catalase [CAT], and glutathione peroxidase [GPx]) levels.
Compared to baseline, TcPo2 in the HBO group increased on day 7 (477.8 ± 118.2 mm
Hg versus 37.06 ± 5.23 mm Hg, P <0.01) and day 14 (501.1 ± 137.7 mm Hg versus
35.61 ± 4.85 mm Hg, P <0.01). Ulcer size reduction in the HBO group was greater
than that of the control group (42.4% ± 20.0% versus 18.1% ± 6.5%, P <0.05). MDA
levels, SOD, and CAT were all significantly higher in the HBO than in the control
group on day 14 (P<0.05). The results of this study suggest HBO treatment for 2
weeks initiates a healing response in chronic DFUs, but the observed oxidative
stress in local ulcer tissue may offset this effect long-term. Until needed
additional research has been conducted, prolonged and/or inappropriate HBO
treatment should be avoided.
PMID: 23475448 [Indexed for MEDLINE]
