Hyperbaric oxygen ther­apy in non-heal­­ing ulcerations –  mechanisms of action, cur­rent european recom­mendations and case report


Authors: M. Hájek 1,2;  J. Klugarová 3;  D. Chmelař 2,4;  M. Klugar 3
Authors‘ workplace: Centrum hyperbarické medicíny, Městská nemocnice Ostrava 1;  Katedra biomedicínských oborů, LF Ostravské univerzity v Ostravě 2;  České národní centrum Evidence-Based Healthcare a Knowledge Translation (Cochrane ČR, České CEHBC: JBI centrum excelence, GRADE centrum MU), Institut biostatistiky a analýz, LF MU, Brno 3;  Referenční laboratoř ČR pro anaerobní bakterie, LF Ostravské univerzity v Ostravě 4
Published in: Cesk Slov Neurol N 2019; 82(Supplementum 1): 56-59
Category: Original Paper
doi: 10.14735/amcsnn2019S56

Overview

Nonheal­­ing ulcers especial­ly in diabetes and critical limb ischemia are the source of major problems and financial costs for both patients and health systems. The causes of diabetic foot ulcers are multifactorial and involve neuropathy and angiopathy, lead­­ing to functional disturbances in the macrocirculation and skin microcirculation. The amputation occurs in about 20% of cases of diabetic foot ulcers. The incidence of amputations in this patient population is 15× higher and make up 50– 70% of all non-traumatic amputations. The main aim of patients, caregivers and healthcare payers should be a reduction of the high rate of major amputations. Despite advances in improv­­ing diabetes care there is still need to identify reserves in the form of new therapeutic strategies and methods. They undoubtedly include the systemic administration of hyperbaric oxygen, which accord­­ing to the cur­rent evidence seems to reduce the need for amputation and increase the number of completely healed wounds.

Keywords:

hyperbaric oxygen therapy – hyperoxia – diabetic foot ulcer – ischaemia – neuropathy – infection


Sources

1. Stryja J, Hájek M. Obtížně se hojící ulcerace a syndrom diabetické nohy. In: Hájek M (ed). Hyperbarická medicína. Praha: Mladá fronta 2017: 264– 284.

2. Stryja J, Turoň J. Léčba ran –  farmakoekonomická data z pohledu poskytovatele a plátce péče. Cesk Slov Neurol N 2017; 80/ 113 (Suppl 1): S18– S 20. doi: 10.14735/ amcsn­n2017 S18.

3. Hájek M. Hyperbarická oxygenoterapie v urgentní medicíně a intenzívní péči. In: Ševčík P, Matějovič M, Černý et al (eds). Intenzivní medicína. 3. vyd. Praha: Galén 2014: 133– 142.

4. Lind F, Öhlén G, Lindén V et al. Focus report –  treatment with hyperbaric oxygen. Stockholms läns landst­­ing 2011: 135.

5. Hájek M. Aktuální situace v poskytování HBO v ČR a ve světě. In: Hájek M (ed). Hyperbarická medicína. Praha: Mladá fronta 2017: 144– 158.

6. Mathieu D, Mar­roni A, Kot J. Tenth European Consensus Conference on Hyperbaric Medicine: recom­mendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Div­­ing Hyperb Med 2017; 47(1): 24– 32. doi: 10.28920/ dhm47.1.24-32.

Labels
Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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