November 17, 2015
HBOT Helps Foot Ulcer Survival
When I wrote that HBOT may not help foot ulcers on April 12, 2013, I was disappointed because I felt that the researchers had missed something or used the wrong pressures. I have now seen three people being treated by hyperbaric-oxygen therapy and all three have foot ulcers that healed with HBOT.
Results of the study were presented at the European Association for the Study of Diabetes (EASD) 2015 Meeting, by lead investigator Magnus Löndahl, MD, of Lund University, Sweden.
A total of 38 patients completed hyperbaric-oxygen treatment, 37 completed placebo treatment, and 19 did not complete treatment (both groups combined). At baseline, hyperbaric oxygen and air patients had had type 2 diabetes for 23 and 21 years, respectively, had a median age of 67 and 71 years, and had foot-ulcer duration of 11.4 and 10.3 months.
What surprises me is the length of foot ulcer duration. I know one of the three had a foot ulcer for 5 months and two others for less than 4 months. In addition, three of our support group have had foot ulcers for less that 4 months and were able to have their foot ulcers healed with medications. This is one reason to see a podiatrist on a quarterly basis, as they examine your feet for foot ulcers, ingrown toe nails and other foot problems. They will also examine your lower legs for problems and refer you to another doctor if necessary.
“Now at 6 years, 63.2% of patients who received at least 37 treatments (of 40 total) of hyperbaric oxygen survived compared with 40.5% of those who got placebo.”
“Dr Giel Nijpels, from the Free University of Amsterdam, the Netherlands, the session moderator, commented on the potential clinical use of hyperbaric oxygen.”
"It seems to work, but we can speculate about the disadvantages, including the high cost. Also, I have some doubts about the way the data were analyzed — I'm unsure if this is fully accurate. The problem is that they attempted to blind the patients, and there was a huge dropout rate.
"Also, let's remember you find this type of treatment only in large academic centers — it isn't that easy to administer this form of therapy," he added.
“Turning his attention to the possible reasons for the positive effect on chronic diabetic foot ulcer, Dr Löndahl said: "I have no definite explanation today. It might be a coincidence or associated with ulcer healing. It is unlikely to be due to improved macrovascular function, but we do have data that improved microvascular function might be associated with survival, not least due to improved autonomic neuropathy."
Despite the positive results, Dr Löndahl concluded that "we need more information and to further explore and verify findings before [this therapy is]…applied in clinical management of diabetic foot ulcer."
I feel that this type of treatment needs to be explored further, as the expense needs to be considered. HBOT does have its place in medicine, especially in diabetes and traumatic brain injury, and possibly other areas besides deep sea diving.