Hyperbaric oxygen therapy for wound healing and limb salvage: a systematic review.

摘要: This article is a systematic review evaluating published clinical evidence of the efficacy hyperbaric oxygen therapy (HBOT) for wound healing and limb salvage. The data source Ovid/Medline database key word "Hyperbaric Oxygenation" with search limits (human studies, 1978-2008). Results were combined by Boolean AND 1 3 following searches: (a) (10 permutations); (b) compromised flap or graft (3); (c) osteomyelitis (1). author evaluated 620 citations, which 64 reported original observational studies randomized controlled trials (RCTs) on HBOT outcomes. All citations 5 subjects selected full text (44 articles) according to GRADE criteria high, medium, low, very low level evidence. A Cochrane identified additional study discusses tabulates every high moderate For patients diabetic foot ulcers (DFU) complicated surgical infection, reduces chance amputation (odds ratio [OR] 0.242, 95% CI: 0.137-0.428) (7 studies) improves (OR 9.992, 3.972-25.132) (6 studies). Positive corresponds HBOT-induced hyperoxygenation at-risk tissue as measured transcutaneous oximetry. associated remission about 85% cases refractory lower extremity osteomyelitis, but an RCT lacking clarify extent effect. There that risk in DFU population promoting partial problem wounds. promotes arterial ulcers, calciphylactic vasculitic well osteomyelitis. successful "take" flaps grafts.