HBOT Treatment for Diabetic Wounds
Hyperbaric Oxygen Therapy (HBOT) involves the use of a chamber in which the air pressure exceeds normal atmospheric pressure, with oxygen being delivered to a patient in higher than normal concentrations. The higher pressure and concentration of oxygen improve oxygen delivery to the affected tissue in wounds, which in turn facilitates healing. The therapy has many medical uses, including treatment for diabetes wounds. Although keeping diabetes under control can prevent such wounds, HBOT offers a viable way to heal wounds that do occur.
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How HBOT Works
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The higher pressure--up to 2.4 times normal--achieves greater oxygenation of the blood. HBOT increases the oxygen in the blood plasma rather than the hemoglobin, which can become saturated with oxygen at normal pressure. As a result, more oxygen penetrates to other fluids in your body. HBOTreatment.com compares the way HBOT increases oxygenation in the body to carbonated beverages, which hold more carbonation under pressure than they do after releasing the pressure. A patient having HBOT enters a pressure chamber, which could be small enough for one person or big enough for several. The chamber might be fixed and made of rigid materials or portable and made of soft materials. Inside, the patient breathes pure oxygen with periodic breaks for breathing normal air.
HBOT for Diabetic Wounds
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Foot wounds often occur in people with diabetes and present doctors with a difficult clinical challenge. According to the Undersea & Hyperbaric Medical Society (UHMS), unhealed diabetic foot wounds account for half of all lower extremity amputations in the United States. With HBOT, the higher oxygen delivery to the affected areas promotes healing and achieves better outcomes in combination with routine wound care than with routine wound care alone.
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Efficacy Studies
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HBOTreament provides abstracts of several clinical studies of patients with diabetic foot wounds. These studies show that HBOT increases oxygenation of the wounds, accelerates healing, heals more wounds and reduces the number of amputations, compared with conventional wound care alone. Three quarters of the patients receiving HBOT improved, compared with about half of those receiving conventional treatment.
Side Effects
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Breathing pure oxygen without periodically breathing normal air can lead to oxygen toxicity; symptoms include seizures, disorientation, difficulty breathing and changes in vision. Prolonged oxygen toxicity can damage the central nervous system, lungs and eyes, although brief exposures usually resolve without problems. Otherwise, the procedure itself appears safe and causes no pain or discomfort, aside from ear popping, such as people experience when changing altitudes in a plane.
Precautions
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A study by Yildiz et al., reported in the October 2008 issue of "Clinical & Investigative Medicine," showed that HBOT in patients with diabetic wounds appears to increase cardiac muscle stress as shown by increases in a certain cardiac neurohormone. The study did not measure if or how long the neurohormone remain elevated but recommended caution in using HBOT in diabetic patients.
Home HBOT also could be a concern. Although portable units can deliver HBOT at home, the UHMS points out that home HBOT often falls short of both the regimens that achieve the efficacy seen in clinical studies as well as federal, state and local safety regulations, particularly regarding the flammability of pure oxygen.
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References
- Undersea and Hyperbaric Medical Society: Enhancement of Healing in Selected Problem Wounds
- HBOTreatment: How Hyperbaric Oxygen Therapy Works
- HBOTreatment: Medical Studies and Articles on Hyperbaric
- Clinical & Investigative Medicine: NT-proBNP Levels...in Diabetic Patients; Yildiz et al., Oct 2008
- Undersea and Hyperbaric Medical Society: Conduct of Hyperbaric Oxygen Therapy at Sites Other Than Clinical Hyperbaric Treatment Facilities
