ABSTRACT
Background: Diabetic foot ulcers (DFUs) are common complications of uncontrolled diabetes mellitus that can result in infection and amputation of the lower extremities. This study compared the benefits and risks of hyperbaric oxygen therapy with those of other DFU treatments, based on the Wagner grading system. Methods: Systematic searches for randomly controlled trials using hyperbaric oxygen therapy for DFUs were performed using PubMed, the Cochrane Library, and Embase. Data regarding demographics, wound healing, minor and major amputations, operative debridement, nonhealing wounds, and adverse effects were analyzed based on Wagner grades, using RevMan 5.4.1 and Microsoft Excel. Results: Hyperbaric oxygen therapy was significantly superior to other treatments for wound healing rates 8 or more weeks after the final treatment (RR = 2.39; 1.87-3.05; P < 0.00001) minor/distal amputations (RR = 0.58; 0.43-0.80; P < 0.007), and major/proximal amputations (RR = 0.31; 0.18-0.52; P < 0.00001) for the 14 studies analyzed. In addition, this therapy increased the rate of complete wound healing for Wagner grades II (RR = 21.11; 3.05-146.03; P = 0.002), III (RR = 19.58; 2.82-135.94, P = 0.003), and IV (RR = 17.53; 2.45-125.44; P = 0.004); decreased the minor/distal amputation rate for grade III (RR = 0.06; 0.01-0.29; P = 0.0004) and the major/proximal amputation rate on for grade IV (RR = 0.08; 0.03-0.25; P < 0.0001); and decreased the operative debridement rate for Wagner grade II (RR = 0.09; 0.01-0.60; P = 0.01). Conclusions: Moderate-quality evidence revealed that adjunctive hyperbaric oxygen therapy improved DFU wound healing for Wagner grades II, III, and IV; prevented minor and major amputations for grades III and IV, respectively; and prevented operative debridement in grade II wounds.
ABSTRACT
Introduction: Trauma to the extremities is a common major health problem that requires special attention because it can have a dangerous impact on both the viability of the limb and the patient's life. Hyperbaric oxygen therapy is an alternative therapy hypothesized to improve the prognosis in lower extremity trauma. Case presentation: We present a series of 7 cases of lower extremity trauma treated with hyperbaric oxygen therapy: soft tissue loss, neglected chronic burn injury, high-voltage electrical burn, gas gangrene, crush injury, chemical burn, and excoriation with skin loss. Discussion: Hyperbaric oxygen therapy involves giving 100% oxygen in a chamber at pressures above atmospheric pressure (2-3 atm absolute [ATA]). It can increase oxygen delivery to peripheral tissues with vascular compromise, cytogenic and vasogenic edema, and cellular hypoxia caused by limb trauma. Conclusion: Hyperbaric oxygen therapy has many benefits in lower extremity trauma for wound recovery, preventing complications, and helping patients return to daily activities.
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INTRODUCTION: Burn injuries are frequently encountered in emergency cases and often become the port of entry for pathogens. More than 450,000 burn injuries occur annually causing nearly 3,400 deaths in the United States. The prevalence of burn injury in Indonesia is 0.7% in 2013. More than half of these According to several studies on the use of patients were treated for bacterial infections, some of which were resistant to certain antibiotics. Using hyperbaric oxygen therapy (HBOT) to treat burns has several positive effects including managing bacterial infections, as well as accelerating the wound healing process. Therefore, this study aims to prove the effectiveness of HBOT in inhibiting bacterial growth. METHODS: This is an experimental research study in rabbits using a post-test control group design. 38 rabbits were given second-degree burns on the shoulder region with a metal iron plate that has been previously heated for 3 min. Bacterial cultures were taken on days 5 and 10 after exposure to the burns. The samples were divided into two groups, HBOT and control. Statistical analyses were performed using the Mann-Whitney U method. RESULTS: Gram-negative bacteria were the most frequently found pathogen in both groups. Citrobacter freundi was the most common Gram-negative bacteria (34%) found in the culture results of both groups.In contrast to the control group, there was no bacterial growth found in the HBOT group's culture results, (0%) vs (58%). A significant reduction of bacterial growth was observed in the HBOT group (69%) compared with the control group (5%). Bacterial levels stagnated in 6 rabbits (31%) in the HBOT group and 7 rabbits (37%) in the control group. Overall, there was significantly less bacterial growth in the HBOT treatment group compared with the control group (p < 0.001). CONCLUSION: HBOT administration can significantly reduce bacterial growth in burn injuries.
ABSTRACT
INTRODUCTION: Hyperbaric oxygen therapy (HBOT) has been applied to urological wound healing because it reduces inflammation, facilitates angiogenesis through endothelial proliferation, stimulates fibroblast, lymphocyte, and macrophage activity, and exerts bactericidal effects. Thus, we present a case series of reconstructive urology wounds treated adjunctively with HBOT. CASE REPORT: Here, we present the cases of eight patients with urology wounds who underwent different forms of surgical reconstruction. Three patients received penile shaft silicone fluid injection with repeated infection, successful excision of a siliconoma mass, and defect closure with a full-thickness skin graft. One patient had hypospadias and multiple post-closure fistulae. Two patients had bilateral keystone flaps (post total penectomy, orchidectomy, perineotomy, and penile tumors) closed with a split-thickness skin graft (STSG). Two patients had Fournier's gangrene in their genital area, for which the wound was debrided and then closed with a STSG. All patients received HBOT after surgery with satisfying results. CONCLUSION: HBOT promotes wound healing and improves graft integration in patients undergoing urological reconstructive surgery.
