Hyperbaric oxygen therapy was originally
used as a scuba diver treatment relating to decompression sickness
but now is used to treat multiple conditions including diabetic
wounds. It can also be used to treat burns and flesh eating wounds
caused by bacteria. It is often promoted as an effective treatment
for diabetic foot wounds and other potentially harmful conditions
such as bone infections and soft tissue injuries relating to
diabetes. People with diabetes need to carefully treat wounds to
avoid health complications. Discover more about diabetes wound care
and hyperbaric oxygen therapy (HBOT).
What is Hyperbaric Oxygen Therapy?
According to Dr. Juan Bravo, an expert in hyperbaric oxygen therapy
at Broward Health in South Florida, “Hypoxia is an insufficient
amount of oxygen and can prevent normal wound healing”. Prior to
this advanced therapy, many people with diabetes who had open wounds
on their limbs often needed amputation due to poor healing.
Hyperbaric oxygen therapy is a way to expose your body to 100
percent oxygen at a higher pressure than normal. Oxygen is essential
to properly heal wounds. By exposing the wound to high levels of
oxygen, the healing process can be quicker in many cases. There are
specific criteria for each patient prior to receiving HBOT.
The therapy is administered inside a chamber that allows the patient
to breathe 100 percent oxygen which is 3 times more than a person
gets in regular air. The intensive oxygen supply helps with wound
healing. The patient is put on a stretcher and slipped into the
chamber or closed tube. The feeling of pressure resembles that of
“being on an airplane”. Patients are allowed to read, listen to
music or watch TV when available. Most times, treatments require
from 10-60 sessions. It is an outpatient procedure that does not
cause pain or require pre-procedure medication which could have
prevented them from driving afterwards. A cotton gown is worn inside
the tube or chamber instead of street clothes which may catch on
fire.
Why is Wound Care Essential for People with Diabetes?
People with diabetes have a compromised immune system which means
they are more prone to infections and other complications when they
have a wound. It can take weeks, or even months, for a wound to
properly heal when you have diabetes. It is important for
people with diabetes to treat wounds immediately. Keep plenty of
wound care supplies on-hand to care for your wound after you learn
how they need to be applied. Proper foot care is also essential to
avoid foot ulcers and wounds that can come from cuts, sores,
blisters, calluses and other food injuries. Never try to cut or
scrape calluses. Gently use a pumice stone to file them down or see
a podiatrist for care. Wash your feet daily with mild soap, lukewarm
water, and dry them with a soft, absorbent towel. Pat your feet dry
rather than rubbing them. Apply moisturizer to your feet after
washing them, making sure to avoid the areas between the toes. If
you have trouble seeing your feet use a mirror. If you have
difficulties reaching them consider a professional pedicure at a
medical office. Wear shoes that fit properly. Have your feet
measured and always wear comfortable, supportive footwear. Stay away
from high heels, open-toed shoes, and flip-flops. Avoid going
barefoot. Wear sturdy slippers at home and water shoes at the beach
or pool.
How Do You Treat a Foot Wound or Other Wound With Diabetes?
People with diabetes must treat the most minor wounds or sores
quickly to avoid possible complications. These wounds can be even
more complex when they occur on the feet or legs due to circulation
and nerve damage. Some people with diabetes have neuropathy that
makes it impossible to feel these wounds or leg sores. Examine your
feet every day for sores or other irregularities. All types of
wounds, even minor ones, should get medical treatment when you have
diabetes. A medical professional knows the proper way to treat and
care for any wound. After the doctor treats your wound a cream may
be prescribed for you to use when you get home. The wound may also
require bandages. If you have a painful open wound on your foot, the
doctor may give you a cast or boot to wear and advise you to stay
off the foot for a few days. In some situations, hyperbaric oxygen
therapy might be recommended to boost the healing process.
What are other options for HBOT?
There are various ways to administer hyperbaric oxygen therapy
besides the tube or chamber. Often topical HBOT is used for people
with diabetes who have small contained foot ulcers or wounds. The
therapy is applied to just that one part of the body. This may be
done by wrapping your foot or leg in a plastic bag that is filled
with 100 percent oxygen that is under pressure. This is a simpler
procedure to perform and typically costs less than other types of
HBOT.
In What Types of Situations Can Hyperbaric Oxygen Therapy Be
Helpful?
For the past three and a half decades, numerous studies have
revealed HBOT can help to speed wound healing for various types of
wounds. According to recent research, “it can be helpful for
diabetes-related wounds, soft tissue infections, and crash injuries,
as well as thermal burns, skin flaps and grafts, and radiation
injuries. It can reduce the risks of health complications by healing
wounds faster than usual”.
Are There Complications Associated with HBOT?
The complications and side effects of HBOT are rare making it a
viable treatment for people with diabetes who have wounds. Possible
side effects may include nearsightedness and decompression sickness.
Some people may experience oxygen toxicity that leads to convulsions
that are not life-threatening. Others may get a level of trauma to
the nose or ears due the high pressure of the oxygen during this
type of therapy.
What Do You Do During an HBOT Treatment?
If you are getting treatment in a chamber, it is often designed for
use by one person. Some large health care facilities have a chamber
that can provide treatments to up to a dozen people, but this is
usually not the situation. Depending on the type of treatment
patients are usually in the chamber for a half hour to two hours.
Patients can breathe normally while they are in the chamber and are
encouraged to relax. The therapist and the patient can see and talk
to each other while the procedure is going on which helps with
anxiety levels of the patient. Once the designated time of the
therapy ends, the chamber is depressurized slowly before the patient
is advised to exit. Some patients feel slightly dizzy or fatigued
after treatments. Other patients’ ears pop, similar to being on a
descending plane.
What Does Research Reveal About HBOT?
Though the procedure has been used to treat diabetic foot ulcers for
over 35 years a debate still exists about whether HBOT is effective.
The treatment may work more slowly than expected but many studies
have indicated it accelerates healing and can minimize
complications. Researchers seem to agree that more data is necessary
to determine whether HBOT is really
effective for treating diabetic foot ulcers. Because it has
shown great potential for long-term healing, HBOT is often
recommended when other treatments have been ineffective at healing
the foot wound. These treatments might include cleansing,
off-loading, the use of antimicrobials, and debridement.
Proper foot care is a top priority for people with diabetes to avoid
wounds that can lead to serious complications. Inspect your feet
every day, report any irregularities to your doctor immediately, and
have them examined by a medical professional. If a wound is
persistent, ask your health care team about the use of hyperbaric
oxygen therapy to try to accelerate healing.