Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...

characteristics compared to the treatment group, which may be predictive of outcome
independent of allocation.
Table 18 Patient criteria of included studies focusing on the use of HBOT in diabetic wounds.*
First Author and Year
of Publication
Patient Criteria
Faglia 1998 48 Consecutive diabetic patients with foot ulcers seen during enrolment period
Zamboni 1997 50
Consecutive, insulin-dependent diabetic patients with non-healing lower extremity wounds
referred for HBOT.
Refusals (n=3) and claustrophobic patients (n=2) served as controls
Faglia 1996 47
Consecutive patients hospitalised for diabetic foot ulcer. Patients had full-thickness gangrene or
abscesses. Subjects with less deep ulcers were included if the ulcer was large, infected, and
showed defective healing in 30 days of outpatient therapy.
Exclusions: refusal (n=1), stroke death (n=1)
Doctor 1992 49 All diabetic patients with chronic foot lesions admitted over the enrolment period.
Baroni 1987 46 All diabetic patients with ulceronecrotic foot lesions seen during the enrolment period.
* Abbreviation: n = sample size
Interventions examined
Three of the five studies46-48 used similar HBOT protocols that involved a two-phase
exposure regimen first described by Baroni and colleagues in 1987. 46 Similar pressures
(2.2 to 2.5 ATA) and exposure durations (90 minutes) were used, and two of the three
studies reported that subjects were exposed to about 35 HBO sessions on average. 46,47
The remaining two studies 49,50 used pressures above or below those used in the first
group (2 or 3 ATA), and exposure times were half as long or a third longer (45 or 120
minutes).
The comparison procedures used consisted of general measures of surgical, infection and
diabetic control, and were similar across studies. Lesions underwent debridement and
topical antimicrobials were applied to local dressings. Empirical antibiotic therapy was
used in the first instance, with the results of microbiological sensitivity guiding
subsequent therapy. For most studies, glycaemic control was achieved using insulin.
Table 19 summarises the therapeutic protocols used.
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