Hyperbaric oxygen therapy for treating non-diabetic chronic wounds
The addition of hyperbaric oxygen to the treatment of chronic, non-diabetic leg ulcers resulted in a reduction in wound area.
Clinical Results:
- The addition of hyperbaric oxygen was associated with a significant reduction in the area of chronic wounds.
- No wounds were completely healed at the end of the six week treatment period, but there was a trend to eventual healing in the hyperbaric group.
Clinical Scenario:
An adult with chronic, non-diabetic leg ulcer in the absence of major arterial/venous vessel disease.
Three-part Question:
In adult patients with chronic, non-diabetic leg ulcers, does the adjunctive use of hyperbaric oxygenation compared to standard wound care alone, result in any improvement in ulcer size or other signs of healing.
The Study:
Double-blinded concealed randomised controlled trial with intention-to-treat.
Leg ulcer present for one year or longer, no major vascular disorder, non-smoking, non-diabetic.
Control group (N = 8): All treatment prescribed at enrollment was continued. Placebo treatment breathing air at 2.5 ATA for 90 minutes daily, 5 days each week to a total of 30 sessions.
Experimental group (N = 8): As above plus addition of hyperbaric oxygenation at 2.5 ATA on the same regime as control group.
The Evidence:
| Outcome | Time to Outcome | Control | Hyperbaric | Relative risk reduction | Absolute risk reduction | Number needed to treat |
| Wound healed | 18 weeks | 0 | 0.333 | INF | 0.333 | 3 |
| 95% CI | 0.71 to 0.04 | NNT= 23 to INF
NNH= 1 to INF |
| Wound area decrease (%) | Air group | HBO group | P-value |
| Week 2 | 2.8 | 6.6 | n/s |
| Week 4 | 3.7 | 22.0 | <0.05 |
| Week 6 | 2.8 | 35.7 | <0.001 |
