Hyperbaric Oxygen Therapy for Nonhealing Wounds – A Long-term Retrospective Cohort Study

SLR - September 2023 - Davis

Title: Hyperbaric Oxygen Therapy for Nonhealing Wounds – A Long-term Retrospective Cohort Study

Reference: Lalieu RC, Bol Raap RD, Smit C, Dubois EFL, van Hulst RA. Hyperbaric Oxygen Therapy for Nonhealing Wounds-A Long-term Retrospective Cohort Study. Adv Skin Wound Care. 2023 Jun 1;36(6):304-310. 

Level of Evidence: IV

Reviewed By: Gabriella Damaris Davis, DPM 
Residency Program:Larkin Community Hospital – Palm Springs Campus Hialeah, FL

Podiatric Relevance: This paper presents an investigation into the efficacy of hyperbaric oxygen therapy (HBOT) in the context of treating nonhealing wounds. The study seeks to shed light on the benefits of HBOT as an adjunctive treatment for various types of nonhealing wounds, particularly in the context of podiatry.  The long-term retrospective cohort study design used in the article allows researchers to assess the benefits of HBOT over an extended period. This is especially relevant in podiatry, where chronic wounds and ulcer management often require ongoing care and monitoring. The findings of the article have direct implications for podiatrists when considering treatment options for patients with nonhealing wounds.

Methods: A retrospective cohort study was performed to assess the effectiveness of HBOT for nonhealing wounds. The researchers extracted data from medical records of 774 patients who were treated with HBOT along with standard wound care in a single center between January 2017 and December 2020. The patients were evaluated based on the level of wound healing at discharge as the primary outcome parameter. The study measured wound healing rates, time to complete healing, and any adverse effects associated with the therapy.

Results: A total of 774 treatment series were recorded, with a median of 39 sessions per patient (interquartile range, 23-51 sessions). In total, 472 wounds (61.0%) healed, 177 (22.9%) partially healed, 41 (5.3%) deteriorated, and 39 (5.0%) minor and 45 (5.8%) major amputations were performed. 

Conclusions: This article significantly contributes to the field of podiatry by providing evidence-based insights into the effectiveness of HBOT for managing nonhealing wounds.  The results indicated a significant improvement in wound healing rates among patients who underwent HBOT. Moreover, the therapy showed positive effects across various wound types, with diabetic foot ulcers and pressure ulcers exhibiting substantial improvement. The study also revealed a reduced risk of infection and the potential to prevent amputations in patients with diabetic foot ulcers.