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Can major amputation rates be decreased in diabetic foot ulcers with hyperbaric oxygen therapy?

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Abstract

Although hyperbaric oxygen therapy has been used for diabetic foot ulcer since the 1980s, there is little information on its efficacy. The aim of this study is to evaluate whether hyperbaric oxygen can decrease major amputation rates and to determine the predictive factors. A total of 184 consecutive patients were treated with hyperbaric oxygen therapy as an adjunct to standard treatment modalities for their diabetic foot ulcer. Of these patients, 115 were completely healed, 31 showed no improvement and 38 underwent amputation. Of the amputations, nine (4.9%) were major amputations (below knee) and 29 were minor. Major amputations were associated with the Wagner grade (p < 0.0001), with the age of the patients (p = 0.028) and with the age of the wounds (p = 0.018). Hyperbaric oxygen therapy can help to reduce the major amputation rates in diabetic foot ulcer. However, further large, multicentre, randomised controlled studies are needed to make more accurate conclusions.

Résumé

Dès 1980, le traitement par oxygène hyperbare a été utilisé pour les lésions des pieds diabétiques avec ulcérations. Les données de la litterature sur l’efficacité de ce traitement semble limitées. Le but de cette étude est d’évaluer si l’utilisation de l’oxygène hyperbare peut diminuer le taux d’amputation et permettre de faire une prédiction concernant l’évolution. Matériel et méthode: 184 patients consécutifs ont été traités par oxygène hyperbare pour leurs lésions sur pieds diabétiques. 115 cas ont complètement guéris, 31 cas n’ont pas du tout été améliorés, 38 ont été amputés. Sur ces amputations 9 (4,9%) ont été des amputations majeures (sous le genou) et 29 mineures. Les amputations majeures sont associées au grade de Wagner (p < 0,0001) à l’âge des patients (p = 0,028) et la durée d’évolution des lésions. Conclusions: l’oxygène hyperbar peut permettre de réduire le taux d’amputations majeures dans les pieds diabétiques avec ulcères. Cependant une étude plus large, multicentrique, randomisée est nécessaire pour conclure de façon plus stricte.

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Acknowledgements

All authors of this study confirm that they have no financial and personal relationships with other people or organisations that could inappropriately influence their work. We thank Dr. Timur Kose for statistical analysis.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Tepecik Training and Research Hospital, 35100, Yenisehir, Izmir, Turkey

    Ahmet Kaya, Taskin Altay, Levent Karapinar & Hasan Ozturk

  2. Neoks Hyperbaric Oxygen Therapy Center, Ankara Cad. No: 197/A, 35560, Bornova, Izmir, Turkey

    Figen Aydin & Cengiz Karakuzu

  3. 2023 S. Nu:2/3, 35540, Bostanli, Karsiyaka, Izmir, Turkey

    Ahmet Kaya

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  1. Ahmet Kaya
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  2. Figen Aydin
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Correspondence to Ahmet Kaya.

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Kaya, A., Aydin, F., Altay, T. et al. Can major amputation rates be decreased in diabetic foot ulcers with hyperbaric oxygen therapy?. International Orthopaedics (SICOT) 33, 441–446 (2009). https://doi.org/10.1007/s00264-008-0623-y

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  • DOI: https://doi.org/10.1007/s00264-008-0623-y

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