A Cochrane review [Abstract] 1 included 12 studies with a total of 577 subjects.
10 trials with 531 patients dealed with diabetic foot ulcers. Pooled data showed an increase in the rate of ulcer healing (RR 2.35, 95% CI 1.19 to 4.62) with hyperbaric oxygen therapy (HBOT) at 6 weeks but this benefit was not evident at longer-term follow-up at one year (RR 9.53, 95% CI 0.44 to 207.76). There was no statistically significant difference in major amputation rate (RR 0.36, 95% CI 0.11 to 1.18; 5 studies, n = 312).
One trial with 16 patients dealed with venous ulcer. This trial reported data at six weeks (wound size reduction) and 18 weeks (wound size reduction and healing rate) and suggested a significant benefit of HBOT in terms of reduction in ulcer area only at 6 weeks (mean difference (MD) 33%, 95% CI 18.97 to 47.03). One trial with 30 patients dealed with non-healing diabetic ulcers as well as venous ulcers. For these mixed ulcers there was a significant benefit of HBOT in terms of reduction in ulcer area at the end of treatment at 30 days (MD 61.88%, 95% CI 41.91 to 81.85) No trials dealed with arterial and pressure ulcers.
Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment and blinding) and by imprecise results (wide confidence intervals), and upgraded by large magnitude of effect.
Primary/Secondary Keywords