Document Detail

Relationship between ulcer healing after hyperbaric oxygen therapy and transcutaneous oximetry, toe blood pressure and ankle-brachial index in patients with diabetes and chronic foot ulcers.
MedLine Citation:
PMID:  20957342     Owner:  NLM     Status:  MEDLINE    
AIMS/HYPOTHESIS: The randomised, double-blind, placebo-controlled Hyperbaric Oxygen Therapy (HBOT) in Diabetic Patients with Chronic Foot Ulcers (HODFU) study showed beneficial effect of HBOT. As this treatment is expensive and time-consuming, being able to select patients for therapy would be very useful. The aim of this study was to evaluate whether circulatory variables could help in predicting outcome of HBOT.
METHODS: All HODFU study participants who completed therapy, predefined as receiving at least 36 out of 40 scheduled HBOT/placebo sessions, were included in this study (n = 75). Baseline transcutaneous oximetry (TcPO₂), toe blood pressure (TBP) and ankle-brachial index (ABI) were measured. Ulcer healing rate was registered at the 9-month follow-up visit. An ulcer was considered healed when it was completely epithelialised and remained so at the 12-month follow-up.
RESULTS: In the HBOT group TcPO₂ were significantly lower for patients whose ulcer did not heal as compared with those whose ulcers healed. A significantly increased healing frequency was seen with increasing TcPO(2) levels in the HBOT group (TcPO₂/healing rate: <25 mmHg/0%; 26-50 mmHg/50%; 51-75 mmHg/73%; and >75 mmHg/100%). No statistically significant relation between the level of TBP or ABI and healing frequency was seen.
CONCLUSIONS/INTERPRETATION: Our results indicate that TcPO₂ in contrast to ABI and TBP correlates to ulcer healing following HBOT. We suggest HBOT as a feasible adjunctive treatment modality in diabetic patients with chronic non-healing foot ulcers when basal TcPO₂ at the dorsum of the foot is above 25 mmHg.
FUNDING: Mrs Thelma Zoegas Foundation and Faculty of Medicine, Lund University.
M Löndahl; P Katzman; C Hammarlund; A Nilsson; M Landin-Olsson
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-10-19
Journal Detail:
Title:  Diabetologia     Volume:  54     ISSN:  1432-0428     ISO Abbreviation:  Diabetologia     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-02     Completed Date:  2011-05-11     Revised Date:  2011-07-22    
Medline Journal Info:
Nlm Unique ID:  0006777     Medline TA:  Diabetologia     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  65-8     Citation Subset:  IM    
Institution for Clinical Sciences in Lund, Lund University, Sweden.
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MeSH Terms
Ankle Brachial Index / methods*
Blood Gas Monitoring, Transcutaneous / methods*
Blood Pressure / physiology*
Diabetic Foot / physiopathology*,  therapy*
Hyperbaric Oxygenation / methods*

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