High transcutaneous oximetry predicts good foot ulcer response to HBOT
MedWire News: A high baseline transcutaneous oximetry (TcPO2) measurement predicts optimal response to hyperbaric oxygen therapy (HBOT) in diabetic patients with chronic foot ulcers, show Swedish study results.
Previous studies have shown that HBOT can be highly beneficial for promoting healing of chronic diabetic foot ulcers, as reported by MedWire News, but the treatment is more successful in some patients than others.
As HBOT is an expensive treatment, Magnus Löhndahl (Skane University Hospital, Lund) and colleagues investigated factors with potential to predict HBOT efficacy.
Using data from the 75 patients enrolled in the HODFU (HBOT in Diabetic Patients with Chronic Foot Ulcers) study who completed at least 36 out of the 40 scheduled HBOT or placebo treatment sessions, the team assessed TcPO2, toe blood pressure (TBP), and ankle-brachial index (ABI) as possible outcome predictors.
Ulcer healing rate was measured 9- and 12-months after the last treatment. Ulcers were considered to be completely healed if completely epithelialized at 9 months, remaining so at 12 months.
For patients in the HBOT group (n=38), TcPO2 was significantly lower in those with an unhealed compared with a healed ulcer.
Healing rate was also lower with decreased TcPO2. More specifically, at a TcPO2 of less than 25 mmHg the healing rate was 0%, increasing to 50% with a TcPO2 of 26-50 mmHg, and increasing still further to 100% with a TcPO2 of 75 mmHg or above.
Of note, TBP and ABI were not significantly associated with HBOT outcome in this study.
Writing in the journal Diabetologia, the authors conclude: "We suggest hyperbaric oxygen therapy as a feasible adjunctive treatment modality in selected diabetic patients with chronic non-healing foot ulcers when basal TcPO2 at the dorsum of the foot is above 25 mmHg."
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By Helen Albert