Chronic diabetic wound
There are 500,000 diabetics in Switzerland and one has to reckon with a diabetic wound requiring intensive treatment in about one in ten diabetics. In Switzerland, the costs of treating diabetic feet have been estimated at one billion francs. The amputation rate is estimated at 1,000 to 2,000 cases per year.
Characteristics of the diabetic foot
The diabetic foot is often deformed with hammer toes, flat feet, claw toes etc. The patient often has a decrease in the sensation of cold, heat or pain. This can lead to small injuries that the patient notices too late. As the diabetic’s circulation is reduced and he is more susceptible to infection, the wound can become chronic and become infected, which can often lead to amputation.
Purpose of processing
Improve and accelerate the healing of chronic and infected diabetic wounds, improve the healing of toe amputation sequelae and thereby prevent larger amputations.
Clinical studies on HBOT
There have been many small scientific studies for more than 40 years that indicate the efficacy of HBOT in the treatment of diabetic foot. The best documented with a one-year follow-up (94 patients) clearly shows the superiority of HBOT in wound healing and the decrease in the amputation rate as well as the improvement in their quality of life compared to placebo . Recently another study found that HBOT does not protect against amputation. Unfortunately she only follows patients for 3 months and bases her conclusions only on the analysis of photos of wounds. The authors concede, however, that HBO patients have less pain and mobility problems than patients without HBO. Another study (120 patients) shows that patients who have had 35 or more sessions of HBOT have fewer amputations than patients who did less. The threshold of 35 sessions for better healing is confirmed by analysis a database of more than 2,000,000 diabetic patients with foot lesions . Recommendations from diabetic foot specialists state that HBOT and negative pressure (VAC) are recommended in the treatment of diabetic foot ischemic , i.e. having circulation disorders.
In a study published in 2020, diabetic patients were cured with HBOT while all patients treated without HBOT required operations.
With a dye, you can already know after the first HBO session if the wound will heal with HBO. The latest review on this topic concludes that HBO is useful for diabetic feet. Impressive work from the Netherlands shows that hospital patients who do not heal suddenly heal when HBOT is added to treatment. International and Australian guidelines recommend to use HBO for diabetic wounds that don’t heal despite correct treatment.
Practical use of HBOT
HBOT is used in addition to conventional surgical and medical treatments, either in stationary or ambulatory application. The treatment takes place once or twice a day. 40 sessions are generally necessary (up to 100 sessions for extreme cases).