Hyperbaric oxygen therapy in non-healing ulcerations - mechanisms of action, current european recommendations and case report

Nonhealing ulcers especially in diabetes and critical limb ischemia are the source of major problems and financial costs for both patients and health systems. The causes of diabetic foot ulcers are multifactorial and involve neuropathy and angiopathy, leading to functional disturbances in the macrocirculation and skin microcirculation. The amputation occurs in about 20% of cases of diabetic foot ulcers. The incidence of amputations in this patient population is 15x higher and make up 50-70% of all non-traumatic amputations. The main aim of patients, caregivers and healthcare payers should be a reduction of the high rate of major amputations. Despite advances in improving diabetes care there is still need to identify reserves in the form of new therapeutic strategies and methods. They undoubtedly include the systemic administration of hyperbaric oxygen, which according to the current evidence seems to reduce the need for amputation and increase the number of completely healed wounds.