Zhao D, Luo S, Xu W, Hu J, Lin S, Wang N, et al.
Clinical therapeutics. Date of publication 2017 Oct 1;volume 39(10):2088-2094.e2.
1. Clin Ther. 2017 Oct;39(10):2088-2094.e2. doi: 10.1016/j.clinthera.2017.08.014.
Epub 2017 Sep 19.
Efficacy and Safety of Hyperbaric Oxygen Therapy Used in Patients With Diabetic
Foot: A Meta-analysis of Randomized Clinical Trials.
Zhao D(1), Luo S(1), Xu W(2), Hu J(1), Lin S(2), Wang N(3).
Author information:
(1)Department of Orthopedics, the First Affiliated Hospital of Shantou University
Medical College, Shantou, Guangdong, China.
(2)Division of Endocrinology and Metabolism, Department of Medicine, the First
Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong,
China.
(3)Division of Endocrinology and Metabolism, Department of Medicine, the First
Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong,
China. Electronic address: wangnasuimd@sina.com.
PURPOSE: The efficacy and safety profile of hyperbaric oxygen therapy (HBOT) in
patients with diabetic foot ulcer have been controversial in recent years. Our
meta-analysis was undertaken to evaluate the efficacy and safety profile of HBOT
in patients with diabetic foot ulcer.
METHODS: We searched the PubMed, Cochrane Library, EMBASE, and Clinical
Trials.gov databases for controlled trials. The efficacy end points included the
incidence of healed ulcers, major amputations, minor amputations, and reduction
in the ulcer wound area. The tolerability end point was the incidence of adverse
events.
FINDINGS: Nine randomized clinical trials involving 526 patients met the
inclusion criteria. No difference was found in the incidence of healed ulcers
(risk ratio [RR] = 2.22; 95% CI, 0.87-5.62; P = 0.32; I2 = 81%), minor
amputations (RR = 0.95; 95% CI, 0.39-2.29; P = 0.91; I2 = 74%), major amputations
(RR = 0.47; 95% CI, 0.17-1.28; P = 0.14; I2 = 61%), and adverse events (RR =
1.00; 95% CI, 0.64-1.56; P = 0.99; I2 = 26%) between the HBOT and standard
therapy (ST) groups. HBOT was associated with a greater reduction in the ulcer
wound area versus ST (standard mean difference = 1.12; 95% CI, 0.20-2.04; P =
0.04; I2 = 70%).
IMPLICATIONS: No differences existed between HBOT and ST with respect to the
incidence of healed ulcers, risk of minor or major amputations, and adverse
events. HBOT was associated with a greater reduction in the ulcer wound area than
ST. HBOT is a clinically meaningful adjuvant therapy for patients with diabetic
foot ulcer.
Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.
DOI: 10.1016/j.clinthera.2017.08.014
PMID: 28935291 [Indexed for MEDLINE]
