What Researchers Did
Researchers conducted a network meta-analysis of 34 randomized controlled trials involving 2,268 diabetic foot ulcer patients to compare the effectiveness of different gas-based therapies, including HBOT, topical oxygen, carbon dioxide, and standard care.
What They Found
HBOT ranked highest for both wound healing rate (SUCRA = 0.814) and wound area reduction (SUCRA = 0.730) compared to all other gas therapies. HBOT significantly outperformed standard care for healing rate (MD = -2.71 sessions difference) and area reduction. However, HBOT also had a higher amputation rate ranking (SUCRA = 0.621), suggesting it may be used in more severe cases. Benefits were greatest when treatment exceeded 6 weeks.
What This Means for Canadian Patients
For Canadians with diabetic foot ulcers, this large meta-analysis confirms HBOT as the most effective gas therapy for wound healing, but also signals it should be used thoughtfully, especially in cases where amputation risk is already high. Longer treatment courses of at least 6 weeks appear necessary for full benefit.
Canadian Relevance
Diabetic foot ulcers are an OHIP-covered indication for HBOT in Ontario, and this high-quality meta-analysis directly supports that coverage.
Study Limitations
There was substantial statistical heterogeneity in wound area reduction results (I² = 87%), and many included studies were of limited quality, requiring cautious interpretation.