Comparison of the Therapeutic Efficacy of Topical Oxygen Therapy and Hyperbaric Oxygen Therapy for Diabetic Foot Ulcers: Short-Term Follow-Up Results

Research Type: Level 3 - Retrospective cohort study, Case-control study, Meta-analysis of Level 3 studies Introduction/Purpose: Diabetic foot ulcers are increasingly common due to the rising population of individuals with diabetes. These ulcers are often resistant to treatment and can lead to various complications. Several methods have been attempted to improve treatment outcomes for diabetic foot ulcers, including hyperbaric oxygen therapy and topical oxygen therapy as means of providing oxygen to the lesions. Topical oxygen therapy has been relatively recently introduced, and there is limited research on its treatment outcomes. The authors aim to report the therapeutic effects of topical oxygen therapy when applied to diabetic foot ulcers, comparing its effectiveness to that of hyperbaric oxygen therapy. Methods: The authors conducted a study involving patients treated for diabetic foot ulcers at a hospital. Both non-surgical wounds and post-surgical wounds were included. Surgical interventions comprised minor amputations, marginal resections, and drainage, while major amputation patients were excluded. Medical records of 21 patients who received either hyperbaric oxygen therapy or topical oxygen therapy for over two weeks were reviewed, and the classification of diabetic wounds according to Wagner's classification ranged from stages 2 to 4. The size of the wounds was measured at the initiation of treatment, and the time taken for the wound size to reduce by half was recorded. Healing rates were compared. Results: Among the 21 patients with diabetic foot ulcers, 12 received hyperbaric oxygen therapy, while 9 received topical oxygen therapy. The time taken for the wound size to decrease by half from the start of either treatment was 26.7 days for the hyperbaric oxygen therapy group and 24.4 days for the topical oxygen therapy group, with no statistically significant difference observed. Some wounds had not yet healed, making comparisons of healing rates impossible. Conclusion: Among the treatment methods for diabetic wounds, the relatively recently introduced topical oxygen therapy demonstrated a similar time frame for the wound size to reduce by half when compared to traditional hyperbaric oxygen therapy. This therapy may be a viable option for patients who cannot undergo hyperbaric oxygen therapy or in environments lacking hyperbaric equipment. However, further well-planned follow-up studies are necessary. Application of topical oxygen therapy. Application of topical oxygen therapy following ray amputation of the second to fifth toes in a 65-year-old male patient with diabetic foot ulcers.