Hyperbaric Oxygen Therapy as an Effective Adjunctive Treatment in the Reconstruction of Tissue Defects With Graft in Diabetic Foot Patients: A Retrospective Cohort Study

Abstract

Diabetic foot patients frequently experience delayed wound healing due to compromised vascularity and oxygenation, which increases the risk of graft failure. Hyperbaric oxygen therapy (HBOT) has demonstrated potential in enhancing graft survival and accelerating wound healing in these patients. This study aimed to assess the efficacy of HBOT in improving graft success and wound healing rates in diabetic foot patients undergoing foot graft reconstruction. Forty-five diabetic patients with tissue defects requiring graft procedures were included. Among these, 28 patients received HBOT (2.4 ATA for 120 min daily), and 17 served as controls. Wound healing was assessed based on milestones of wound closure (25%, 50%, 75% and complete healing). The control group consisted of patients with adequate graft nutrition who did not require HBOT or were unable to undergo HBOT for other reasons. Statistical analyses were performed to compare healing times and graft retention rates between the two groups. Patients in the HBOT group exhibited significantly faster healing, with a median time to 50% healing of 18 days compared to 30.5 days in the control group (p < 0.05). A moderate negative correlation was observed between graft retention rates and time to complete healing (p < 0.05), indicating that higher graft retention was associated with shorter healing times. Despite higher HbA1c levels in the HBOT group, favourable healing outcomes were achieved. No adverse effects were reported in the HBOT group. HBOT significantly enhances graft survival and accelerates wound healing in diabetic foot patients, even in cases with poor glycaemic control. HBOT emerges as a valuable adjunctive treatment for patients with compromised vascular beds and hypoxic tissues. Future randomised controlled trials are needed to validate these results.