The Physiological, Biochemical and Quality of Life Changes in Chronic Diabetic Foot Ulcer after Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) was established to increase oxygenation and antimicrobial effect that potentially improve the healing of chronic ulcer. Present study  aim  to  assess  the  effects  of  HBOT  in  chronic  diabetic  foot  ulcer  (DFU).  A total  of  sixty  patients  classified  according  to  Wagner  1,  2  or  3  chronic  diabetic foot ulcers, were recruited and subsequently divided randomly into two groups; HBOT and control group. All patients underwent the standard treatment for DFU, but for the HBOT group, underwent 20 HBOT sessions, each lasted 80 – 90 mins at 2.5 atmospheres absolute (ATA). White cell count (WCC) and C-reactive protein (CRP) levels were taken during inclusion, at second and fourth week of treatment. Wound  sizes  were  documented  at  each  follow  up  until  six  months  follow  up. SF-36  at  one-month  post  hyperbaric  oxygen  therapy  was  used  to  measure  the health-related  quality  of  life.  Reduction  of  WCC  and  CRP  in  HBOT  group  were significant throughout the treatment (p=0.046 and p=0.039, respectively). A total of  26  patients  (86.7%)  from  the  HBOT  group  achieved  complete  ulcer  healing at  six  months’  follow-up,  while  18  patients  (60%)  in  the  control  group’s  ulcer healed completely. Patients treated with HBOT had significantly better mental and physical health constituent of quality of life. It must be emphasised that HBOT is an adjunctive therapy to the standard management of chronic DFU in accelerating wound healing for a better quality of life.