Hyperbaric oxygen therapy as an adjuvant to standard therapy in the treatment of diabetic foot ulcers

Background and Aims: Chronic diabetic foot ulcers pose a major problem because of associated limb threatening complications. The aim of the present study was to evaluate the efficacy of hyperbaric oxygen therapy (HBOT) as an adjuvant to standard therapy for treatment of diabetic foot ulcers. Material and Methods: A total of 54 patients with diabetic foot ulcer of Wagner grade II-IV were recruited in this prospective, randomized, double blind study. Patients were randomized to receive HBOT along with standard therapy (group H; n = 28) or standard therapy alone (group S; n = 26). Patients were given 6 sessions per week for 6 weeks and followed up for 1 year. Outcomes were measured in terms of healing, and need for amputation, grafting or debridement. Parametric continuous variables were analyzed using Student unpaired t-test and categorical variables were analyzed using Chi square test. Results: The diabetic ulcers in 78% patients in Group H completely healed without any surgical intervention while no patient in group S healed without surgical intervention (P = 0.001). 2 patients in group H required distal amputation while in Group S, three patients underwent proximal amputation. Conclusion: The present study shows that hyperbaric oxygen therapy is a useful adjuvant to standard therapy and is a better treatment modality if combined with standard treatment rather than standard treatment alone for management of diabetic foot ulcers.