What Researchers Did
Researchers conducted a meta-analysis of 10 randomized controlled trials to compare extracorporeal shockwave therapy (ESWT) against standard wound care and HBOT for healing diabetic foot ulcers.
What They Found
ESWT was 57% more likely to result in complete ulcer healing compared to controls (RR 1.57, 95% CI 1.26–1.95). Subgroup analysis showed ESWT outperformed both HBOT and standard care alone. ESWT also significantly improved tissue oxygen levels. Adverse events were not significantly higher with ESWT.
What This Means for Canadian Patients
Diabetic foot ulcers affect roughly 15–25% of people with diabetes in Canada and are a leading cause of amputation. While HBOT remains a valuable option for these wounds, this meta-analysis suggests ESWT may also deserve a place in treatment plans, potentially as a complement to HBOT.
Canadian Relevance
Diabetic foot ulcers are an OHIP-covered indication for HBOT in Ontario. This meta-analysis is directly relevant to clinical decisions for this patient population.
Study Limitations
Only 10 trials were included and their methodological quality was rated as moderate, with significant variation in how HBOT was delivered across studies.