Fife CE, Buyukcakir C, Otto G, Sheffield P, Love T, Warriner R 3rd, et al.
Wound repair and regeneration : official publication of the Wound Healing Society [and] the Eur.... Date of publication 2007 May 1;volume 15(3):322-31.
1. Wound Repair Regen. 2007 May-Jun;15(3):322-31.
Factors influencing the outcome of lower-extremity diabetic ulcers treated with
hyperbaric oxygen therapy.
Fife CE(1), Buyukcakir C, Otto G, Sheffield P, Love T, Warriner R 3rd.
Author information:
(1)Department of Anesthesiology, The University of Texas Medical School at
Houston, Texas, USA. Caroline.E.Fife@uth.tmc.edu
The objectives of this study were to report outcomes of a large number of
patients receiving hyperbaric oxygen therapy (HBO(2)T) for diabetic
lower-extremity ulcers, and to identify likely outcome predictors. Five
hyperbaric facilities supplied data on 1,006 patients. A sixth clinic served as a
validation sample for the regression-based prediction model, and later additional
data from Memorial Hermann Hospital were added. The severity of lower-extremity
lesions was assessed upon initiation of HBO(2)T using the Modified Wagner scale,
and the outcome described as healed, partially healed, not improved, amputated,
or died. Overall, 73.8% of patients improved (granulated or healed). Factors
significantly related to outcome included renal failure, pack-year smoking
history, transcutaneous oximetry, number of HBO(2)T treatments, and interruption
of treatment regimen. Number of treatments per week and treatment pressure (2.0
vs. 2.4 atmospheres absolute) were not significant factors in outcome.
Concomitant administration of autologous growth factor gel did not improve
outcome. A multiple regression model was fitted to the data that can be used to
predict the outcome of diabetic patients undergoing HBO(2)T. Given the high cost
of amputation and rehabilitation, these data suggest that hyperbaric oxygen
treatment should be an important adjunctive therapy to heal lower-extremity
lesions, especially those with a Wagner grade of 3 or higher.
DOI: 10.1111/j.1524-475X.2007.00234.x
PMID: 17537119 [Indexed for MEDLINE]
