Systematic Review: Effectiveness, Safety, and Quality of life for Diabetic Foot Ulcer patients with Hyperbaric Oxygen Therapy

Diabetic foot ulcers are often associated with amputation of the lower extremities. Hyperbaric oxygen therapy is considered an adjuvant to accelerate wound healing and reduce the number of amputations in diabetic foot ulcer patients. The systematic review aimed to confirm the effect of hyperbaric oxygen therapy as an adjunct therapy in diabetic foot ulcer patients. PUBMED, SCOPUS, and COCHRANE will be used as databases. Eligible articles include those that compare hyperbaric oxygen therapy with standard therapy in diabetic foot ulcer patients published until March 2024. The main outcomes measured include wound healing, incidence of amputation, side effects, mortality, and quality of life. Two reviewers independently screened, extracted data, and assessed the risk of bias for the included papers. The COCHRANE system and ROBINS-I were used to assess the quality of studies. The search yielded 953 results, of which 39 full-text articles were evaluated for relevance. Sixteen studies met the inclusion criteria. Thirteen studies were randomized controlled trials. There were significant differences in wound healing and major amputations, whereas there were no significant differences in minor amputations. Six studies reported side effects of barotrauma and two studies reported no side effects in patients. Hyperbaric oxygen therapy improves wound healing and major amputations compared to standard therapy. Further research is needed, especially regarding patient criteria and the number of hyperbaric oxygen therapy sessions to be able to determine which one gets the most effective.