Learn about the causes, symptoms, and treatment options for diabetic foot ulcers, including the innovative use of Hyperbaric Oxygen Therapy (HBOT) in a hyperbaric chamber.
What is a diabetic foot ulcer?
A diabetic foot ulcer is an open sore or wound that usually occurs on the sole in patients with diabetes. This complication is the result of a combination of factors, including peripheral nerve sensory impairment and autonomic nerve damage caused by diabetic neuropathy, as well as peripheral arteriolar occlusive disease or skin microangiopathy caused by lower extremity arteriosclerosis.
The incidence of diabetic foot ulcers is about 15%, but this proportion may be as high as 25%. Among diabetic patients who develop foot ulcers, approximately 6% will be hospitalized for infection or other complications, and 14-24% of patients will eventually require non-traumatic lower limb amputation. Foot ulcers usually occur before 85% of diabetes-related amputations.
Causes of diabetic foot ulcers
The high blood sugar levels in diabetics can lead to nerve damage, which can cause the feet to lose their normal ability to sense pain. Patients can suffer foot injuries without knowing it, such as soaking their feet in hot water or wearing uncomfortable shoes.
Vasculopathy in diabetics can lead to poor blood circulation in the feet, reducing the supply of oxygen and nutrients, increasing the risk of ulcer formation, and delaying the healing process.
Abnormal foot structure increases local pressure, causing skin abrasions and ulcers.
A high blood sugar environment favors bacterial growth, increasing the risk of infection and further worsening ulcers.
People who have diabetes for many years are more likely to develop neuropathy and vasculopathy, which increase the risk of foot ulcers.
Symptoms of diabetic foot ulcers
Many people with diabetic foot ulcers do not feel pain due to nerve damage.
In the early stages of an ulcer, people may notice fluid seeping from their socks.
The ulcer may be red and swollen.
When the infection is severe, the ulcer may emit a foul odor.
Severe foot ulcers may be surrounded by black tissue, called gangrene, which is a sign that the tissue lacks a normal blood supply.
What is Hyperbaric Oxygen Therapy (HBOT)?
Hyperbaric Oxygen Therapy (HBOT) is a medical device that allows patients to inhale pure or high-concentration oxygen in an environment with a pressure higher than one atmosphere. The chamber is a closed cylindrical container, and high-pressure oxygen or high-pressure air is input through pipes and control systems to form a high-pressure environment in the chamber. When patients receive oxygen therapy in the chamber, they can provide effective and sufficient oxygen to the hypoxic body, increase the oxygen storage in the tissues, and thus achieve the purpose of treatment.
What diseases can be treated in a hyperbaric oxygen chamber?
- Diabetic foot ulcer
- Anaerobic infection: such as gas gangrene, etc.
- Carbon monoxide poisoning: Hyperbaric oxygen can quickly replace carboxyhemoglobin in the blood.
- Gas embolism: Hyperbaric oxygen can reduce the volume of gas embolism and relieve symptoms.
- Decompression sickness: Hyperbaric oxygen can accelerate the discharge of nitrogen and relieve the symptoms of decompression sickness.
- Ischemic hypoxic encephalopathy: such as cerebral infarction, brain trauma, etc.
- Cerebral vascular disease: such as cerebral hemorrhage, cerebral thrombosis, etc.
- Postoperative trauma: such as severe craniocerebral injury, burns skin grafting, etc.
- Complications after organ transplantation: Hyperbaric oxygen can promote the survival and functional recovery of transplanted organs.
- Other diseases: such as sudden deafness, chronic osteomyelitis, etc.
Can a Hyperbaric Oxygen Chamber (HBOT) Help Treat Diabetic Foot Ulcers?
Hyperbaric Oxygen Therapy (HBOT) has shown significant clinical effects in the treatment of diabetic foot ulcers.
The therapeutic mechanism of HBOT in treating diabetic foot ulcers
- Increase blood oxygen partial pressure and tissue oxygen partial pressure:
The hyperbaric oxygen chamber significantly increases the amount of dissolved oxygen in the plasma by increasing the concentration and pressure of oxygen inhaled by the patient. This increases the blood oxygen partial pressure and tissue oxygen partial pressure, helping to improve the hypoxic state at the site of diabetic foot ulcers and promote wound healing.
- Improve microcirculation:
Hyperbaric oxygen can enhance the deformability of red blood cells, inhibit the blood coagulation system, reduce blood viscosity, speed up blood flow, and reduce platelet aggregation, thereby improving microcirculation. This helps increase the blood supply to the affected foot, accelerate inflammation absorption, and repair tissue.
The hyperbaric oxygen environment can inhibit the growth of anaerobic bacteria and reduce the production of toxins. It can also increase the oxygen level in the tissue, allowing macrophages to exert their oxygen-killing activity and thereby effectively control the infection.
- Promote the role of growth factors:
Hyperbaric oxygen can increase the concentration of carbon monoxide (CO) at the local ulcer and promote the release of growth factors such as epidermal growth factor and vascular endothelial growth factor. Accelerate tissue renewal and growth and promote ulcer healing.
Hyperbaric oxygen therapy can significantly reduce pain and improve the quality of life of patients with diabetic foot ulcers.
Other treatment options for diabetic foot ulcers
The treatment of diabetic foot ulcers is a multidisciplinary and comprehensive process involving a variety of methods and means. The following are some commonly used treatment options and their specific mechanisms and effects:
- Control blood sugar
- Improve blood circulation
- Debridement and wound treatment
- Infection management
- Surgical treatment
- Physical therapy
Hyperbaric oxygen therapy (HBOT): Improves microcirculation, controls infection, and promotes wound healing by increasing blood oxygen partial pressure and tissue oxygen partial pressure. Hyperbaric oxygen therapy is particularly suitable for patients with Wagner grades 1-3.
- Electrical stimulation: Promote wound healing and improve local blood circulation through electrical stimulation.
Laser therapy: Use laser to improve local blood circulation and promote tissue growth.
- Rehabilitation and care
- Foot decompression:
Use non-removable knee-high decompression devices, removable knee-high decompression devices, ankle-high decompression devices or suitable shoes and socks combined with foam pads to reduce foot pressure and promote ulcer healing.
Keep your feet clean, check your feet regularly, and detect and deal with potential problems promptly.
- Quit smoking and drinking:
Smoking and drinking will inhibit blood circulation and increase the risk of ulcers, so you need to quit smoking and drinking.
formulate a reasonable diet plan, control weight, and reduce mechanical stress.
strengthen health education for patients, improve their self-management ability, and reduce ulcer recurrence.
