ADJUNCTIVE HYPERBARIC-OXYGEN THERAPY IN THE TREATMENT OF THE DIABETIC FOOT

Hyperbaric oxygen therapy is currently used as an adjunct in the treatment of a variety of lower limb lesions, particularly of the diabetic foot, that heretofore have been refractory to more traditional therapies. Recent investigators have documented that tissue hypoxia is a major factor in the pathophysiology of these disorders. Hyperbaric oxygen therapy administered in specially designed pressure vessels can attack this problem directly, periodically raising tissue oxygen tensions to normal or even supranormal levels. The elevation of abnormally low oxygen tensions enhances bacterial killing by polymorphonucleocytes, stimulates fibroblasts to synthesize collagen, and provides a matrix for enhanced angiogenesis. Utilization of adjunctive hyperbaric oxygen therapy as part of an aggressive approach to selected lower extremity lesions can result in cost-effective salvage and reduction of morbidity.