Ludwik Fedorko
Toronto General Hospital University Health Network | Canada
Title: Role of hyperbaric oxygen therapy in treatment of diabetic wounds?
Biography
Biography: Ludwik Fedorko
Abstract
Hyperbaric Oxygen (HBO) has been increasing in popularity as an adjuvant treatment for difficult to heal diabetic wounds. Critical review of literature as well as results of our own work challenge the notion that this is the effective and efficatious treatment modality. A brief review of that evidence will be presented. The most recent clinical guidelines supporting HBO use for diabetic wound are often based on expert opinions and poorly controlled studies with significant biases. A recent, very large dataset retrospective review of prospectively collected multicenter data, with propensity matching methodology, failed to find benefits of HBO for any group of diabetic patientsn with difficult to heal wounds. Similarly, our own prospective double blind, placebo controlled study have failed to show benefit of HBO in any of measured wound healing outcomes, when comprehensive wound care was applied equally in sham and HBO group. HBO is a very time consuming and cost intensive modality requiring daily sessions for six to eight weeks. There are other treatment modalities which were demonstrated to be effective in a properly controlled clinical studies, at lower costs or/and patient time involvement. HBO by its very nature and cost may possibly prohibit some patients from obtaining access to several more effective and immediate treatments. We will discuss the rational path to successful healing of difficult diabetic wounds based on the most current scientific evidence