The Physiological, Biochemical and Quality of Life Changes in Chronic Diabetic Foot Ulcer after Hyperbaric Oxygen Therapy
Hyperbaric Oxygen Therapy and Quality of Life
Abstract
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.
Keywords :
oxygenation,
quality of life,
wound healing,
Abstrak
Terapi Oksigen Hiperbaric (TOH) dikesan dapat meningkatkan pengoksigenan dan kesan anti-mikrob yang berpotensi meningkatkan penyembuhan ulser kronik. Kajian ini bertujuan menilai kesan TOH dalam ulser kaki diabetik (UKD) yang kronik. Seramai enam puluh pesakit dikelaskan mengikut Wagner 1, 2 atau 3 ulser kaki diabetik kronik dan dibahagikan secara rawak kepada dua kumpulan; TOH dan kawalan. Semua pesakit menjalani rawatan piawai untuk UKD, tetapi bagi kumpulan TOH menjalani 20 sesi TOH, yang berlangsung selama 80 - 90 minit pada 2.5 atmosfera mutlak (ATA) setiap sesi. Bilangan sel putih dan tahap protein C-reaktif telah diambil semasa kemasukan wad, pada minggu kedua dan keempat rawatan. Saiz luka didokumentasikan pada setiap susulan sehingga enam bulan susulan. Soal selidik SF-36 selepas pesakit menjalani terapi oksigen hiperbarik telah digunakan untuk mengukur kualiti kehidupan dan kesihatan. Pengurangan sel putih dan protin C-reaktif dalam kumpulan TOH adalah ketara sepanjang rawatan berbanding kumpulan kawalan (p = 0.046 dan p = 0.039 masing-masing). Seramai 26 pesakit (86.7%) daripada kumpulan TOH telah mencapai penyembuhan ulser pada enam bulan susulan, manakala hanya 18 pesakit (60%) dalam kumpulan kawalan telah sembuh sepenuhnya pada enam bulan susulan. Pesakit yang dirawat dengan TOH menunjukkan konstituen kesihatan mental dan fizikal jauh lebih baik dalam soal selidik kualiti kehidupan. Adalah ditekankan bahawa TOH adalah terapi tambahan kepada rawatan ulser kaki diabetik yang kronik dalam mempercepatkan penyembuhan luka bagi memastikan kualiti hidup pesakit yang lebih baik.
Kata Kunci :
kualiti kehidupan,
pengoksigenan,
penyembuhan luka,
Correspondance Address
Mohd Yazid Bajuri. Department of Orthopaedics and Traumatology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur, Malaysia. Tel: +60391456031 Fax: +603-91456674 E-mail:ezeds007@yahoo.com.my
