Fifteen percent of all diabetics will develop diabetic foot ulcers at some point. Currently, more than 17 million people in the US have diabetes, with another one million cases diagnosed per year. Of these patients, up to 70% have some degree of diabetic neuropathy or peripheral vascular disease, which can both lead to diabetic foot ulcers. If left untreated, or even with full conventional treatment, the ulcers may lead to serious consequences. These consequences include gangrene, infections and osteomyelitis. In addition, most diabetic amputation cases begin with foot ulcers. If a patient’s body exhibits an inability to heal on its own within one month of symptoms, it is likely that continued problems will exist, eventually leading to amputation.
Diabetic foot ulcers can, for many patients, seem to appear out of nowhere. Diabetics tend to lose sensation in the feet; therefore, they are more easily injured and they may not even notice that the injury has occurred. This can leave these ulcers untreated for a period of time and leave them susceptible to serious infection. Once a patient presents with a diabetic foot ulcer, a physician will need to determine if the ulcer is ischemic (caused by narrowing of the arteries), neuropathic (actual injury to the nerve) or a combination of both. Traditional treatment involves bandaging, using an anti-bacterial topical product and an orthotic to keep the pressure off the ulcer. This traditional method does not have an impressive success rate when used alone, but when combined with hyperbaric chamber treatment, the statistics show a significant rise. For instance, diabetics suffering with foot ulcers who undergo traditional treatment avoid amputation 61% of the time. However, with added hyperbaric oxygen therapy, the number rises to 89%.
Hyperbaric oxygen therapy involves little participation from the patient. The patient simply lies inside the hyperbaric chamber and breathes normally. While in the chamber, the patient is exposed to 100% oxygen and 2 to 3 times the normal atmospheric pressure. This pressure is equivalent to a diver reaching 50 feet underwater. This method of therapy exposes the infected tissues to high concentrations of oxygen. The atmospheric pressure increases the level of dissolved gases in the patient’s blood by 2 to 3 times its normal amount. In other words, the oxygen dissolved in the blood increases from 0.32% to 6.8%.
Cianci P. Adjunctive hyperbaric oxygen therapy in the treatment of the diabetic foot. J Am Podiatr Med Assoc. 1994;84:448–455 Doctor N, Pandya S, Supe A. Hyperbaric oxygen therapy in diabetic foot. J Postgrad Med. 1992;38:112–114