The Efficacy of Hyperbaric Oxygen in the Treatment of Chronic Ulcers

Background: Chronic ulcers are a significant socio-economic problem and represent a major risk factor for hospitalization, amputation, sepsis and even death. The treatment of chronic ulcers is often difficult and painful. Experimental results have shown that hyperbaric oxygen therapy (HBOT) is useful to the treatment of chronic ulcers and particularly in diabetic ulcers. The objective of this literature review was to research the effectiveness of HBOT in healing chronic ulcers.

Methods: A review of the literature was performed, in electronic databases PubMed, Cinahl, Iatrotek on-line and in Health Sciences Library with the following key words: “chronic ulcers”, “wound healing”, “HBOT”, “HBOT in chronic ulcers”, “venous ulcers”, “diabetic ulcers”, “pressure ulcers”.

Results: Ten randomized controlled trials, one retrospective trial and one clinical trial, were included. Nine studies involved patients with diabetic ulcers, in one study patients with venous ulcers, in one study patients with diabetic and venous ulcers and in one study patients with pressure ulcers. HBOT improves the healing rate of wounds and the period of the treatment, reduces the size of the wounds and the risk of amputation in diabetic ulcers. In venous and pressure ulcers the effectiveness of HBOT is still unclear, due to the minimum number of available trials.

Conclusion: There is evidence that the use of HBOT can improve healing of chronic ulcers, but the available results are inadequate to prove it clearly. Any benefit from HBOT should be further examined in unbiased randomized trials.