Summary of Study
The systematic review titled “Clinical Outcomes of Hyperbaric Oxygen Therapy for Diabetic Foot Ulcers: A Systematic Review“ evaluates the effectiveness of hyperbaric oxygen therapy (HBOT) in managing diabetic foot ulcers (DFUs), a severe complication of diabetes that often leads to limb amputation. Researchers analyzed six studies involving 391 patients, comparing HBOT with standard care (SC) to assess its impact on ulcer healing, amputation rates, and wound dimensions. The study aimed to provide clinical evidence for HBOT’s utility and to identify areas where further research is needed.
Methodology
A comprehensive literature search was conducted from November 2024, spanning PubMed, Scopus, and Web of Science databases. Researchers included studies published between 2016 and 2024 that evaluated systemic HBOT for DFUs, focusing on ulcers of Wagner grade 3 or higher. Inclusion criteria required studies with clearly defined outcomes such as healing rates, amputation frequency, and ulcer size reduction. Exclusion criteria eliminated studies on topical oxygen therapy, non-diabetic ulcers, or studies with incomplete data. The studies included randomized controlled trials (RCTs) and observational research, assessed for bias using the Cochrane RoB 2.0 and ROBINS-I tools.
Results
Four out of six studies showed significant improvements in healing rates and reductions in major amputations with HBOT compared to SC. One study reported a 33.3% full closure rate in HBOT-treated patients versus none in the SC group. Reductions in ulcer dimensions were also noted. However, some studies, such as Fedorko et al., found no significant differences in long-term outcomes, likely due to methodological inconsistencies. Common limitations included performance bias due to inadequate blinding and inconsistent HBOT protocols. While most studies reported positive results, findings were influenced by variations in patient selection and study design.
Conclusion
HBOT shows promise as a complementary therapy for DFUs, offering improved healing and reduced amputation rates. However, further large-scale, multicenter RCTs with standardized protocols are essential to confirm its effectiveness and determine which patients benefit most. Evaluating its cost-effectiveness and impact on quality of life will also be vital for integrating HBOT into routine DFU management.
Source: Clinical Outcomes of Hyperbaric Oxygen Therapy for Diabetic Foot Ulcers: A Systematic Review | Damineni U, Divity S, Gundapaneni S, et al. (February 06, 2025) | Cureus 17(2): e78655 | DOI: 10.7759/cureus.78655
