Abstract

AIM: To compare the vascularisation in diabetic foot ulcers before and after the hyperbaric oxygen treatment. MATEREAL AND METHOD: Among the patients admitted to our hospital for diabetic foot ulcers, 14 of them with Wagner-2 to degree 4 ulcer were included for our prospective study. Tissue biopsies were taken from the margin between ulcer and healthy tissue under local anesthesia so that the vascularisation can be compared both in ulcer and normal tissue. The vascularisation was evaluated by a single pathologist as mi İd, moderate and dense vascularisation. The biopsy specimens taken from two patients were inadequate for evaluation of vascularisation and they ha ve been excluded. Biopsies were performed in each case before and after hyperbaric oxygen treatment. An informed consent was taken in each patient. Hyperbaric oxygen treatment was applied in a private center, 6 sessions a week (Sundays off), totally 40 sessions in each case. Duration of each session was minimal 120 minutes and the pressure was about 2,4 ATA. Data were analysed statistically by Fisher's exact test in SPSS 15.0 for windows. FINDINGS: The average age was 60.3 + 14.5 in twelve patients. 4 of them was female and 8 male. The average duration of diabetes mellitus was 19.3 + 7.2 years of the 12 patients. Vascular endothelial density was mild in 5 patients, moderate in other 5 patients and dense in two before hyperbaric oxygen treatment. After treatment, vascular endothelial density was moderate in 9 patients and dense in 3 patients. The difference was statistically significant (p<0,05). Clinical follow-up revealed that improvement of wound healing was observed in 9 patients, while no change was in a case and a second case did not change. Finger amputation was needed only in one patient. CONCLUSION: Our study has confırmed that the hyperbaric oxygen treatment has increased the vascularisation of diabetic foot ulcers-and improved wound healing process.