Outcome of Chronic Foot Osteomyelitis Treated With Hyperbaric Oxygen: An Observational Study

Int J Low Extrem Wounds. 2024 Mar;23(1):80-85. doi: 10.1177/15347346231217641. Epub 2023 Dec 10.

Abstract

Chronic refractory osteomyelitis of the foot stands as a formidable challenge in medical care, associated with significant morbidity and escalating healthcare costs. Traditional therapeutic approaches, including surgical debridement and systemic antibiotics, often fall short, leaving patients and clinicians in search of more efficacious interventions. Hyperbaric oxygen therapy (HBOT), an innovative therapeutic modality, has recently emerged as a promising adjunct therapy, offering a beacon of hope in this therapeutic conundrum. In this groundbreaking observational study, we meticulously analyzed the experiences of 80 patients suffering from chronic refractory osteomyelitis of the foot. Following surgical debridement and tailored antibiotic therapy, each patient was treated with HBOT at 2.5 atmospheres absolute for 120 min, 5 days a week, spanning an average of 50 days. Our primary endpoints focused on complete eradication of infection, recurrence metrics, and any adverse effects linked to HBOT. Astonishingly, 68 of the 80 patients (85%) achieved a total infection clearance, maintaining this status through a mean follow-up period of 36 months, all without a single report of HBOT-induced complications. Our compelling findings advocate that HBOT, synergized with standard surgical and antibiotic regimens, can revolutionize the treatment landscape for chronic refractory osteomyelitis of the foot. Given these promising preliminary results, there's an imperative need for extensive research to delineate the long-term advantages and to fine-tune HBOT protocols, potentially paving the way for a new therapeutic gold standard.

Keywords: adjunctive treatment; chronic osteomyelitis; foot infection; hyperbaric oxygen therapy; infection eradication.

Publication types

  • Observational Study

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Chronic Disease
  • Diabetic Foot* / complications
  • Diabetic Foot* / diagnosis
  • Diabetic Foot* / therapy
  • Humans
  • Hyperbaric Oxygenation* / methods
  • Osteomyelitis* / complications
  • Osteomyelitis* / diagnosis
  • Osteomyelitis* / therapy

Substances

  • Anti-Bacterial Agents