Hyperbaric Oxygen Therapy in Diabetic Foot

Hyperbaric Oxygen Therapy (HBOT) in Diabetic Foot Management

A Powerful Adjunct for Healing, Infection Control & Limb Salvage

Diabetic foot ulcers (DFUs) are considered among the most severe complications of diabetes and should be treated using Diabetic foot management as soon as possible to avoid the severe outcomes. In cases where blood sugar levels are uncontrolled over a long period of time, this will cause a decrease in blood circulation, worsening infection in ulcer, and nerve damage (neuropathy) will arise. Consequently, either a minor wound on the foot might result in a non-healing ulcer and might advance to gangrene in case it is not addressed promptly.

Lack of blood also slows down the supply of oxygen and nutrients and thus, natural healing is extremely slow. Loss of sensation does not allow injuries to be detected early enough, which permits the infection to progress further into tissues and even bone. Hbot of diabetic foot and Hbot of gangrene are addressed as a part of comprehensive care in the case of the advanced cases. The effects of Hyperbaric oxygen therapy treatment (HBOT) included in regular wound care increase oxygen delivery and promote tissue repair as well as the overall healing outcomes.

What is a Diabetic Foot Ulcer?

A diabetic foot ulcer is an open wound, which is often observed on the bottom (plantar surface) of the foot. It can be similar to a red, callus lesion of the skin with thickened or callused skin.

Common symptoms include:

• Mulcted heat and erythema beneath the foot.
• Swelling and tenderness
• Foul smell
• Edema of peripheral limb
• Skin discoloration
• Visible open wound

Early diagnosis is essential in successful Diabetic foot management.

The Challenge in Diabetic Foot Management

The reason is that many diabetic ulcers do not heal due to:

• Hypoxia- A lack of oxygen in the tissues.
• Ischemia -Poor blood circulation.
• Infection -possibility of anaerobic bacteria and osteomyelitis.
• Neuropathy- Decreased sensation, slows down the process.

Normal wound care is at times problematic due to lack of oxygen, which is the important fuel in the process of healing, to the wound.

It is at this point that HBO therapy treatment is of great help.

What is Hyperbaric Oxygen Therapy (HBOT)?

HBOT entails the inhalation of 100 percent pure oxygen in a pressurized room. This elevated pressure in the atmosphere enables oxygen to directly dissolve into the blood plasma and this is known to reach regions where circulation is impaired.

The oxygen in the HBOT is similar to a drug- it sparks off healing at a cellular level.

How HBOT Works in Diabetic Foot & Gangrene

1 Flooding the Tissue with Oxygen

HBOT pressurizes oxygen into the plasma, circumventing the ruptured red blood cells to the ischemic tissues.

This renders Hbot particularly effective in diabetic foot in poorly perfused wounds.

2 Tissue Regeneration & New Vessel Growth

HBOT stimulates:

• Fibroblast activity
• Collagen formation
• Angiogenesis (the development of new blood vessels)

This hastens the process of granulation tissue and wound healing.

3 Fighting Infection

• Kills anaerobic bacteria
• Enhances that of the white blood cells.
• Increases the efficacy of antibiotics.

This comes in especially handy in Hbot in gangrene where infection control is of the essence.

4 Reduces Swelling & Inflammation

HBOT minimizes the edema and enhances microcirculation, which leaves the wound bed clean and healthier.

Wagner Grading & When HBOT is Recommended.

Wagner Grading & When HBOT is Recommended

The Wagner Grading System, according to it, states that:

• Grade 1 : No Visible Ulcer 
• Grade 2: Superficial ulcers
• Grade 3: Deep abscess or osteomyelitis ulcer.
• Grade 4: Localized gangrene
• Grade 5: Extensive gangrene

HBOT is particularly prescribed in case of:

• Wagner Grade 3–5 ulcers
• Failure to heal in 46 weeks of normal treatment.
• Chronic osteomyelitis
• The healing of the post-amputation stump.

Primary Goal: Limb Salvage

The final objective of the Hyperbaric oxygen therapy treatment in diabetic ulcers of advanced cases is to minimise major amputations. Research indicates that the limbs are highly likely to be saved upon incorporation of HBOT to the common wound treatment.

In diabetic foot, early application of Hbot can save the lives of patients with severe infection or gangrene by avoiding amputation.

Important: HBOT is Part of a Multi-Modal Approach

HBOT is not a magic solution all by itself. Successful Diabetic foot management should also involve:

• Strict blood sugar control
• Surgical debridement
• Appropriate antibiotics
• Off-loading pressure
• Proper footwear

HBOT and its combined application have significant positive effects on healing.

Conclusion

Hyperbaric oxygen therapy (HBOT) is an evidence-based and advanced adjunct treatment in the management of diabetic foot. Hyperbaric oxygen therapy treatment is critical by aiding in saving limbs and enhancing quality of life, through enhanced tissue repair, combating infection and minimizing inflammation.

The Hbot of diabetic foot and Hbot of gangrene are life-changing in that cases of non-healing ulcer or early gangrene gangrene may be initiated right on time.

Embarking on early intervention = Positive healing outcome = Increased likelihood of limb salvage.