Hyperbaric oxygen in diabetic gangrene treatment

Diabetes Care. Jan-Feb 1987;10(1):81-6. doi: 10.2337/diacare.10.1.81.

Abstract

We treated a group of 18 hospitalized adult diabetic patients (all with retinopathy, 17 with symptomatic neuropathy, and 6 with macroangiopathy) presenting with gangrenous lesions of the foot by a combined regime consisting of strict metabolic control, daily debridement of necrotic tissues, and daily hyperbaric oxygen (HBO) treatments given in a multiplace oxygen chamber. Another group of 10 adult subjects with comparable foot lesions (all with retinopathy, 9 with symptomatic neuropathy, and 4 with macroangiopathy) was treated in exactly the same way except for HBO. In the test treatment group, 16 patients were healed, and the remaining 2 showed no improvement and later underwent amputation. The number of HBO treatments required for healing was significantly related to the size of gangrenous lesions. In the non-HBO-treated group, only 1 patient improved, 5 of 10 showed no change, and 4 of 10 worsened until leg amputation was unavoidable. Comparison of the two groups by chi 2-test revealed a highly significant difference (P = .001). In practical terms, HBO treatment drastically reduced leg amputations in patients so treated in the last 3 yr compared with earlier and current figures for patients not receiving HBO treatment.

MeSH terms

  • Adult
  • Aged
  • Diabetes Complications*
  • Diabetic Angiopathies / complications
  • Diabetic Neuropathies / complications
  • Diabetic Retinopathy / complications
  • Female
  • Foot Diseases / etiology
  • Foot Diseases / therapy*
  • Gangrene / etiology
  • Gangrene / therapy*
  • Humans
  • Hyperbaric Oxygenation*
  • Male
  • Middle Aged
  • Skin Ulcer / therapy