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Hyperbaric Chamber For Diabetic Wound Healing

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Diabetes Induction And Glucose Levels

Hyberbaric chamber helps diabetics heal from wounds

Female WAG/RijHsd rats , on average 8 weeks old and with an average weight of 134.4 ± 7.9 g, were used in the study. Following STZ injection, all rats became hyperglycemic: 50 rats had blood glucose levels > 19 mmol/L in the period after the STZ injection until their experimental endpoint. In five rats the blood glucose levels gradually dropped towards the end of the experiment however, these animals still had blood glucose levels > 10 mmol/L at all times during their experimental period. In four rats, blood glucose levels dropped to normoglycemia in the diabetes induction period these animals were reinjected with STZ and then maintained glucose levels of > 20 mM during the remainder of the study protocol.

All 55 rats showed similar behavior and were included in the analysis. No significant differences in mean blood glucose level were observed between the two groups during the treatment period.

Hyperbaric Oxygen Therapy For Wound Healing In Diabetic Rats: Varying Efficacy After A Clinically

  • Affiliation Department of Plastic and Reconstructive Surgery, Erasmus MCUniversity Medical Center, Rotterdam, the Netherlands

  • Affiliation Department of Plastic and Reconstructive Surgery, Erasmus MCUniversity Medical Center, Rotterdam, the Netherlands

  • Affiliation Department of Plastic and Reconstructive Surgery, Erasmus MCUniversity Medical Center, Rotterdam, the Netherlands

  • Affiliation Department of Plastic and Reconstructive Surgery, Erasmus MCUniversity Medical Center, Rotterdam, the Netherlands

  • Affiliation Department of Plastic and Reconstructive Surgery, Erasmus MCUniversity Medical Center, Rotterdam, the Netherlands

  • Affiliation Department of Plastic and Reconstructive Surgery, Erasmus MCUniversity Medical Center, Rotterdam, the Netherlands

The Benefits Of Hyperbaric Oxygen Therapy For Limb Salvage & Wound Healing

It wasnt too long ago that amputation was the only viable treatment option for severe ulcers, tumors, and injuries on the feet and legs.

Now, thanks to remarkable technological advances, its possible for doctors to use limb salvage techniques to reconstruct injured limbs without the need for amputation.

Limb salvage treatment helps cancer patients, diabetics, victims of trauma, and many others by removing severe injuries and infections without compromising the patients overall quality of life.

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What Happens If Your Diabetic Wound Doesnt Receive Proper Care

Unfortunately, your diabetic wound wont simply disappear if you ignore it. Instead, a wound like a diabetic foot ulcer will become more and more severe until it threatens your entire foot or even your life. In fact, diabetic foot ulcers precede about 85% of all amputations performed on adults with diabetes!

When diabetic wound care treatment doesnt occur properly, your diabetic wound will most likely progress into a deep infection that kills healthy tissue and delivers infection directly into your bone. This type of infection is hard to stop once it begins, making amputation the only procedure capable of halting the spread of infection and saving your life.

This is why the most common diabetic amputations occur on the toes, feet, and lower legs. More than 70,000 Americans endure amputations due to diabetic complications every year, but theyre largely preventable with proper diabetic wound care and attention.

How Hbot Can Help Diabetic Patients With Their Wound Healing

All About Hyperbaric Therapy And Chambers For Wound Healing

Diabetes affects the rate in which the body heals wounds. People with diabetes have difficulty metabolizing glucose, causing high blood sugar levels that affect the bodys ability to respond to wounds and heal itself.

For non-diabetic people, a small cut or abrasion will often heal with no complications. But for people with diabetes, a small cut on the foot can lead to sores and ulcers that are slow to heal and, as a result, are more likely to develop infections and complications.

These complications can unfortunately sometimes lead to limb amputation. According to Point: Hyperbaric Oxygen Is Beneficial for Diabetic Foot Wounds, Diabetic foot ulcers occur in 1.9% of adults with diabetes annually, resulting in amputation in 15%20% of patients within 5 years.

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Why Is Oxygen So Important For Successful Wound Healing

Most of the core functions involved in wound healing are oxygen-dependent, so it makes sense that increasing oxygen in the body can support the wound-healing process.

Theres no one single reason that certain parts of the body become deprived of oxygen. Instead, its a complex problem of supply and demand. Many factors have the potential to decrease the supply of oxygen into the blood and cells, including heart disease, radiation therapy, and tissue inflammation.

Its also possible for oxygen demand to surge in response to the bodys needs and ultimately outpace oxygen supply. Think of it as oxygen economics within the body!

Patient Selection And Monitoring

Before referral for adjunctive hyperbaric oxygen therapy, a patient should have demonstrated no progress toward healing while receiving standard care. Failure to recognize correctable arterial insufficiency will result in a poor or nondurable response to hyperbaric oxygen therapy. Optimally, each patient referred for hyperbaric oxygen therapy should have a comprehensive vascular surgery consultation, including regional arterial perfusion indices, toe-brachial indices, and measurements of the periwound TcPO2 level. Similarly, wounds that exhibit normal levels of tissue oxygenation usually fail to heal only when not appropriately off-loaded.

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How Is Limb Salvage Treatment Performed

Limb salvage requires collaboration by a team of experts: a wound care doctor, wound care nurses, vascular surgeons, orthopedic surgeons, infectious disease specialists, prosthetic experts, and hyperbaric oxygen therapy specialists team together to provide the very best outcome for limb salvage patients.

A few of the most prevalent limb salvage techniques include the following:

  • Debridement and cleaning of infection
  • Realign bones to prevent complications of abnormal pressure on the skin
  • Install prostheses or bone grafts that fuse with original bone and make normal limb movement possible

Overall, limb salvage is performed to eliminate the potential cause of a future amputation and maintain or improve function of the affected limb.

The Most Common Diabetic Wounds

Using Hyperbaric Chambers To Heal Wounds

Wounds can develop anywhere on the body, but diabetics are most vulnerable to cuts, scrapes, and sores on their lower extremities.

Diabetic wounds do occur on the knees and legs, but theyre most frequently found on the feet in the form of diabetic foot ulcers. Given that diabetic foot problems are the most common cause of hospitalization among diabetic patients, proper treatment is essential to long-term health.

WHAT IS A DIABETIC FOOT ULCER?

A diabetic foot ulcer begins just like any normal wound. It might be a cut, scrape, blister, or other minor injury. The complications of poorly controlled diabetes, including slow circulation and nerve damage, prevent such wounds from healing normally. Instead, the skin breaks down further and exposes deeper layers of tissue to bacteria and infection.

DO YOU HAVE A DIABETIC FOOT ULCER?

Since nerve damage may prevent you from feeling the pain of your diabetic foot ulcer, its important to visually inspect your feet every day. If you notice any of the following signs, seek medical care immediately:

  • Drainage from your foot is staining your socks or leaking from your shoe
  • Unusual swelling
  • Strong, irregular odor from one or both feet
  • Black tissue surrounding a wound on the foot

Many diabetic foot ulcers develop under the big toe and along the balls of the feet. The earlier you can identify your diabetic foot ulcer and receive treatment, the better your chances of preventing severe complications.

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Studies Show Positive Results

A 2010 study, published in Diabetes Care, a journal that shares diabetes-related research, is just one example. The results showed that adjunctive treatment with HBOT facilitates healing of chronic foot ulcers in selected patients with diabetes. This was a randomized, placebo-controlled, clinical trial that included 94 patients with grade 2, 3, and 4 diabetic foot ulcers.

A 2016 report in the World Journal of Diabetes shared by the U.S. National Library of Medicine also discusses HBOT as a diabetic foot ulcer treatment. The report says that the holistic therapy could reduce “tissue hypoxia, edema, increase angiogenesis and erythrocytes deformability, antimicrobial effects and increase fibroblastic activity. In other words, HBOT has the ability to increase the amount of oxygen reaching body tissue, which may be able to reduce swelling and inflammation, as well as promote blood vessel growth, prevent bacterial infections, and help heal the wound.

Dr. Katz, who has more than 27 years of experience as a physician and leader in hyperbaric medicine, adds, “The positive results Ive seen in my career have been significant.”

If you are a diabetic with a foot ulcer or know someone who might benefit from HBOT, schedule a consultation with HMS to learn more. Our professional staff will assess whether HBOT may be helpful, and if so, create a customized protocoland even suggest other treatments as wellto maximize and optimize your chances of healing.

How Successful Is Hbot On Diabetes

The aim is to increase the supply of oxygen to the tissue, and help the wound to heal better. Hyperbaric oxygen therapy ameliorates glucose tolerance in diabetic patients. Studies have shown that hyperbaric oxygen therapy could be used as a therapeutic intervention for type 2 diabetes. The treatment takes place in a pressurized chamber where the air pressure is increased to 2 or 3 times the outside atmosphere.

The air inside the chamber is 100% oxygenated. Hyperbaric oxygen therapy sessions take place every day over a period of several weeks or months. One session usually lasts about 1 to 2 hours. This treatment is always done in addition to the normal treatments for wounds. It cant replace intensive wound care but it does assist with the healing process.

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Hyperbaric Oxygen Therapy For Diabetic Foot Wounds

Hyperbaric oxygen therapy has been used to treat diabetic foot wounds for over 20 years. The first controlled trial was reported in the medical journal Diabetes Care. Proponents of HBOT have suggested that the demonstrated benefits of HBOT, including improving wound tissue hypoxia, enhancing perfusion, reducing edema, downregulating inflammatory cytokines, promoting fibroblast proliferation, collagen production, and angiogenesis, make it useful for problems like foot ulcers.

HBOT has been used in the past to treat difficult conditions such as soft tissue bone infections, improving leukocyte and macrophage function, and enhancing the effect of antimicrobials. Therefore, HBOT has been suggested to dramatically reduce the risk of amputation in diabetic patients with foot wounds. Both patients and providers look to avoid amputation, and more clinical trials are needed to cement HBOT as a powerful treatment for diabetes.

Hyperbaric oxygen therapy is showing promising results for the treatment of diabetic conditions.

What Are Other Options For Hbot

Do Hyperbaric Oxygen Treaments Heal Chronic Wounds ...

There are various ways to administer hyperbaric oxygen therapy besides the tube or chamber. Often topical HBOT is used for people with diabetes who have small contained foot ulcers or wounds. The therapy is applied to just that one part of the body. This may be done by wrapping your foot or leg in a plastic bag that is filled with 100 percent oxygen that is under pressure. This is a simpler procedure to perform and typically costs less than other types of HBOT.

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Effect Of Diabetes And Hbot On Body Weight

The average loss of body weight during the first week after STZ injection was 4% . At the end of the diabetes induction phase the average body weight had increased to 104% of the starting weight with no significant differences between the groups assigned to the subsequent HBOT or control treatment.

Analysis of the body weight data during the experimental phase on a per-group basis showed no significant differences in body weight between the HBOT and control groups that had their experimental endpoint on day 7 and day 14.

On an average of 7 weeks after diabetes induction, two pressure ulcer wounds were created on the dorsal skin of each animal. During the wound-healing phase, HBOT rats showed a significantly increased body weight in experimental week 4 and in experimental week 5 .

Adverse Effects Of Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy is generally well tolerated. The pressure and duration of oxygen exposure used in hyperbaric oxygen therapy are chosen to minimize the likelihood of adverse effects and may be modified for patients with a history of seizure or obstructive lung disease, to further reduce the risk of treatment morbidity.

Adverse effects of pressurization and depressurization result from expansion of gases in enclosed anatomic compartments. Otic barotrauma may result from the inability of the patient to equalize pressure across the tympanic membrane. This may occur in 2%4% of patients and may require temporary tympanostomy or pressure equalization tubes in some. Sinus barotrauma is less frequent, usually occurring in the presence of a concurrent upper respiratory infection, and it rarely requires permanent discontinuation of hyperbaric oxygen therapy. Pulmonary obstructive disease may rarely lead to lung overpressurization during decompression. The incidence of pneumothorax during routine hyperbaric therapy is estimated to be < 1 in 1,000,000 exposures.

Although the mechanism of action is unclear, transient myopia may occur in < 10% of patients during hyperbaric oxygen therapy. The incidence of this increases if the number of treatments is extended beyond the 4060 usually used in the United States. This visual change resolves over weeks to months after the conclusion of therapy .

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What Are Diabetic Wounds And Ulcers

An ulcer is a type of wound that is an open sore, and it happens to almost 15 per cent of patients that are a victim of diabetes. It usually occurs on the bottom of the foot. If they are not treated on time and accurately, they easily can get severe and results in further dangerous complications. It can even result in making the foot useless. From the 15 per cent of the ulcer patients, 6 per cent sadly end up in the hospital due to various ulcer related complications.

People who use insulin for the management of diabetes are the most common victims of diabetes ulcer or diabetic wounds. The patients who get their kidney weak due to diabetes are also on the same list of high-risk for diabetes wounds.

Tip: Everything about Diabetic Wound Care and Treatment were covered previously.

Tip: Its best to use Best Wound Dressing Products for the best outcomes.

What Does Research Reveal About Hbot

Hyperbaric Chamber Healing Powers

Though the procedure has been used to treat diabetic foot ulcers for over 35 years a debate still exists about whether HBOT is effective. The treatment may work more slowly than expected but many studies have indicated it accelerates healing and can minimize complications. Researchers seem to agree that more data is necessary to determine whether HBOT is really effective for treating diabetic foot ulcers. Because it has shown great potential for long-term healing, HBOT is often recommended when other treatments have been ineffective at healing the foot wound. These treatments might include cleansing, off-loading, the use of antimicrobials, and debridement.

Proper foot care is a top priority for people with diabetes to avoid wounds that can lead to serious complications. Inspect your feet every day, report any irregularities to your doctor immediately, and have them examined by a medical professional. If a wound is persistent, ask your health care team about the use of hyperbaric oxygen therapy to try to accelerate healing.

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The Procedure Of Hyperbaric Oxygen Therapy

Hyperbaric Oxygen Therapy is a medical technology that doesnt require hospitalization as the treatment is considered an outpatient procedure. However, if a patient is already in the hospital and under observation, then the doctors may prefer to perform the therapy as an inpatient procedure. There are also some situations depending upon the condition and nature of the disease in the patient that can cause the patient to get a transfer to a hyperbaric oxygen facility .

Tip: Did you know How to Choose the Best Doctor to Treat Your Diabetes Wounds? If not, just follow the link.

You should remember, every hospital does not have hyperbaric chambers. Usually, less than 10% of hospitals in a given country have hyperbaric chambers.

The transfer of patients depends on how severe their condition is as some patients become very sensitive and would struggle in a room full of other patients.

Physiologic Rationale And Other Uses

The physiological pathways of normal wound healing remain incompletely defined. After initial injury and an inflammatory phase in which inflammatory cells migrate to the area, hypoxia and elevated lactate in the wound center stimulate fibroblast replication, collagen production, and endothelial cell growth . This stimulation and ingrowth of tissue from the wound edges is optimal in the presence of a steep oxygen gradient from the periphery to the hypoxic center . The high concentration of dissolved oxygen during hyperbaric oxygen treatment optimizes this concentration gradient and facilitates wound repair.

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How Can Hyperbaric Oxygen Therapy Help With Limb Salvage And Wound Care

Hyperbaric oxygen therapy for wound healing and limb salvage is a powerful treatment option.

Without a continuous supply of fresh oxygen through the blood, wounds simply cant heal. Most patients who require limb salvage already have a condition like diabetes or peripheral vascular disease that restricts circulation and, as a result, the availability of oxygen to wounds.

Hyperbaric oxygen therapy overcomes oxygen and circulation deficiencies by infusing the entire body with oxygen that permeates the blood and travels to all areas of the body. As soon as sufficient amounts of oxygen and nutrients are available, the bodys innate healing process begins. White blood cells enter the wound to fight infection, oversee the repair process, and build new, healthy tissue.

Since the goal of limb salvage is to remove infected tissue while protecting the bone and limb, HBOT offers an essential way to enhance the bodys natural healing capabilities and maximize the results of limb salvage.

When you use HBOT to treat your diabetic wound and prevent amputation, you can expect to experience significant benefits to your overall health:

  • Increase the cells responsible for closing wounds and forming a barrier on the skin
  • Boost antibacterial activity and response to antibiotics
  • Stimulate the creation of new, healthy blood cells and collagen
  • Support growth factor activity to regular wound healing

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