What Researchers Did
Researchers reviewed medical and economic evidence, and gathered patient experiences, to assess whether adding hyperbaric oxygen therapy (HBOT) to standard wound care helps treat diabetic foot ulcers compared with standard wound care alone.
What They Found
This health technology assessment reviewed seven randomized controlled trials and one non-randomized controlled trial comparing standard wound care plus HBOT with standard wound care alone, and rated the overall quality of the evidence as low. Results for major amputation rates were mixed. There was a significant difference favouring standard wound care plus HBOT on the outcome of ulcers healed, though this finding was also rated low quality. The review also found no difference between the two groups on at least one other outcome, though the abstract does not specify which one.
What This Means for Canadian Patients
For Canadians with diabetic foot ulcers that are not healing with standard wound care, this assessment suggests adding HBOT may improve the chance of the ulcer healing, but the low quality of the evidence means this result is uncertain, and the effect on preventing major amputation is unclear. Patients and clinicians should weigh this uncertainty when discussing HBOT as an add-on therapy.
Canadian Relevance
This assessment was prepared for Ontario's Ministry of Health and Long-Term Care and published in the Ontario health technology assessment series, making it a directly Canadian (Ontario) source. No specific funding or coverage decision for HBOT is stated in the abstract.
Study Limitations
The body of evidence was rated low quality under GRADE criteria, drew on only seven randomized trials and one non-randomized trial, and produced mixed or incompletely reported results across outcomes.