Efficacy of oxygen therapy for diabetic foot ulcers: a network meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

NING Peng , ZHANG Jiaxing , CAO Hongyi ,  YANG Jing

Department of Endocrine and Metabolism, Chengdu Fifth People’s Hospital (The Second Clinical Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Geriatric Diseases Institute of Chengdu, Chengdu 611137, P. R. China;

Corresponding author：

YANG Jing, Email: 510163393@qq.com

Keywords：

Diabetic foot ulcers; Hyperbaric oxygen; Topical oxygen; Ozone; Efficacy; Network meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.202404036

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the efficacy of oxygen therapy for diabetic foot ulcers (DFUs). Methods The PubMed, Embase, Cochrane Library, CNKI, WanFang Data, and VIP databases were electronically searched to collect randomized controlled trials (RCT) on the efficacy of different oxygen therapies for DFUs from inception to April 1, 2024. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Statistical analysis was performed using R software, and GraphPad Prism was used for graphical representations. Results A total of 61 RCTs involving 4 306 DFUs cases were included in the analysis. The oxygen therapies examined primarily included hyperbaric oxygen, topical oxygen, and ozone therapy. The surface under the cumulative ranking curve (SUCRA) indicated that hyperbaric oxygen therapy ranked highest for healing rate, area reduction rate, and healing time (SUCRA values were 0.957, 0.868, and 0.869, respectively). However, hyperbaric oxygen therapy also ranked higher for amputation rate and adverse events (SUCRA values were 0.616 and 0.718, respectively). Further subgroup analysis revealed that hyperbaric oxygen therapy maintained the highest ranking in area reduction rate across subgroups defined by publication language and treatment duration. Conclusion Hyperbaric oxygen therapy shows advantages in terms of healing rate, area reduction rate, and healing time for DFUs, but it is also associated with higher amputation rates and adverse events. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.

1.	McDermott K, Fang M, Boulton AJM, et al. Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers. Diabetes Care, 2023, 46(1): 209-221.
2.	Primadhi RA, Septrina R, Hapsari P, et al. Amputation in diabetic foot ulcer: a treatment dilemma. World J Orthop, 2023, 14(5): 312-318.
3.	Chen L, Sun S, Gao Y, et al. Global mortality of diabetic foot ulcer: a systematic review and meta-analysis of observational studies. Diabetes Obes Metab, 2023, 25(1): 36-45.
4.	Armstrong DG, Tan TW, Boulton AJM, et al. Diabetic foot ulcers: a review. JAMA, 2023, 330(1): 62-75.
5.	Wenhui L, Changgeng F, Lei X, et al. Hyperbaric oxygen therapy for chronic diabetic foot ulcers: an overview of systematic reviews. Diabetes Res Clin Pract, 2021, 176: 108862.
6.	Yellin JI, Gaebler JA, Zhou FF, et al. Reduced hospitalizations and amputations in patients with diabetic foot ulcers treated with cyclical pressurized topical wound oxygen therapy: real-world outcomes. Adv Wound Care (New Rochelle), 2022, 11(12): 657-665.
7.	Astasio-Picado Á, Babiano AÁ, López-Sánchez M, et al. Use of ozone therapy in diabetic foot ulcers. J Pers Med, 2023, 13(10): 1439.
8.	Kwee E, Borgdorff M, Schepers T, et al. Adjunctive hyperbaric oxygen therapy in the management of severe lower limb soft tissue injuries: a systematic review. Eur J Trauma Emerg Surg, 2024, 50(3): 1093-1100.
9.	Frykberg R, Andersen C, Chadwick P, et al. Use of topical oxygen therapy in wound healing. J Wound Care, 2023, 32(Sup8b): S1-S32.
10.	Kushmakov R, Gandhi J, Seyam O, et al. Ozone therapy for diabetic foot. Med Gas Res, 2018, 8(3): 111-115.
11.	Chen P, Vilorio NC, Dhatariya K, et al. Guidelines on interventions to enhance healing of foot ulcers in people with diabetes (IWGDF 2023 update). Diabetes Metab Res Rev, 2024, 40(3): e3644.
12.	ElSayed NA, Aleppo G, Aroda VR, et al. 2. Classification and diagnosis of diabetes: standards of care in diabetes-2023. Diabetes Care, 2023, 46(Suppl 1): S19-S40.
13.	van Netten JJ, Bus SA, Apelqvist J, et al. Definitions and criteria for diabetes-related foot disease (IWGDF 2023 update). Diabetes Metab Res Rev, 2024, 40(3): e3654.
14.	Shim SR, Kim SJ, Lee J, et al. Network meta-analysis: application and practice using R software. Epidemiol Health, 2019, 41: e2019013.
15.	Mbuagbaw L, Rochwerg B, Jaeschke R, et al. Approaches to interpreting and choosing the best treatments in network meta-analyses. Syst Rev, 2017, 6(1): 79.
16.	Higgins JPT, Thomas J, Chandler J, et al. Cochrane handbook for systematic reviews of interventions version 6.4 (updated August 2023). Cochrane, 2023.
17.	Doctor N, Pandya S, Supe A. Hyperbaric oxygen therapy in diabetic foot. J Postgrad Med, 1992, 38(3): 112-114.
18.	Faglia E, Favales F, Aldeghi A, et al. Adjunctive systemic hyperbaric oxygen therapy in treatment of severe prevalently ischemic diabetic foot ulcer: a randomized study. Diabetes Care, 1996, 19(12): 1338-1343.
19.	Abidia A, Laden G, Kuhan G, et al. The role of hyperbaric oxygen therapy in ischaemic diabetic lower extremity ulcers: a double-blind randomised-controlled trial. Eur J Vasc Endovasc Surg, 2003, 25(6): 513-518.
20.	Kessler L, Bilbault P, Ortéga F, et al. Hyperbaric oxygenation accelerates the healing rate of nonischemic chronic diabetic foot ulcers: a prospective randomized study. Diabetes Care, 2003, 26(8): 2378-2382.
21.	Duzgun AP, Satir HZ, Ozozan O, et al. Effect of hyperbaric oxygen therapy on healing of diabetic foot ulcers. J Foot Ankle Surg, 2008, 47(6): 515-519.
22.	Löndahl M, Katzman P, Nilsson A, et al. Hyperbaric oxygen therapy facilitates healing of chronic foot ulcers in patients with diabetes. Diabetes Care, 2010, 33(5): 998-1003.
23.	Ma L, Li P, Shi Z, et al. A prospective, randomized, controlled study of hyperbaric oxygen therapy: effects on healing and oxidative stress of ulcer tissue in patients with a diabetic foot ulcer. Ostomy Wound Manage, 2013, 59(3): 18-24.
24.	Fedorko L, Bowen JM, Jones W, et al. Hyperbaric oxygen therapy does not reduce indications for amputation in patients with diabetes with nonhealing ulcers of the lower limb: a prospective, double-blind, randomized controlled clinical trial. Diabetes Care, 2016, 39(3): 392-399.
25.	Chen CY, Wu RW, Hsu MC, et al. Adjunctive hyperbaric oxygen therapy for healing of chronic diabetic foot ulcers: a randomized controlled trial. J Wound Ostomy Continence Nurs, 2017, 44(6): 536-545.
26.	Santema KTB, Stoekenbroek RM, Koelemay MJW, et al. Hyperbaric oxygen therapy in the treatment of ischemic lower- extremity ulcers in patients with diabetes: results of the DAMO2CLES multicenter randomized clinical trial. Diabetes Care, 2018, 41(1): 112-119.
27.	Perren S, Gatt A, Papanas N, et al. Hyperbaric oxygen therapy in ischaemic foot ulcers in type 2 diabetes: a clinical trial. Open Cardiovasc Med J, 2018, 12: 80-85.
28.	Dhamodharan U, Karan A, Sireesh D, et al. Tissue-specific role of Nrf2 in the treatment of diabetic foot ulcers during hyperbaric oxygen therapy. Free Radic Biol Med, 2019, 138: 53-62.
29.	Salama SE, Eldeeb AE, Elbarbary AH, et al. Adjuvant hyperbaric oxygen therapy enhances healing of nonischemic diabetic foot ulcers compared with standard wound care alone. Int J Low Extrem Wounds, 2019, 18(1): 75-80.
30.	Kumar A, Shukla U, Prabhakar T, et al. Hyperbaric oxygen therapy as an adjuvant to standard therapy in the treatment of diabetic foot ulcers. J Anaesthesiol Clin Pharmacol, 2020, 36(2): 213-218.
31.	Wadee AN, Fahmy SM, El-Deen HAB. Low-level laser therapy (photobiomodulation) versus hyperbaric oxygen therapy on healing of chronic diabetic foot ulcers: a controlled randomized trial. Phys Ther Rev, 2021, 26: 73-80.
32.	Yu J, Lu S, McLaren AM, et al. Topical oxygen therapy results in complete wound healing in diabetic foot ulcers. Wound Repair Regen, 2016, 24(6): 1066-1072.
33.	Driver VR, Reyzelman A, Kawalec J, et al. A prospective, randomized, blinded, controlled trial comparing transdermal continuous oxygen delivery to moist wound therapy for the treatment of diabetic foot ulcers. Ostomy Wound Manage, 2017, 63(4): 12-28.
34.	Niederauer MQ, Michalek JE, Liu Q, et al. Continuous diffusion of oxygen improves diabetic foot ulcer healing when compared with a placebo control: a randomised, double-blind, multicentre study. J Wound Care, 2018, 27(Sup9): S30-S45.
35.	Frykberg RG, Franks PJ, Edmonds M, et al. A multinational, multicenter, randomized, double-blinded, placebo-controlled trial to evaluate the efficacy of cyclical topical wound oxygen (TWO2) therapy in the treatment of chronic diabetic foot ulcers: the TWO2 study. Diabetes Care, 2020, 43(3): 616-624.
36.	Serena TE, Bullock NM, Cole W, et al. Topical oxygen therapy in the treatment of diabetic foot ulcers: a multicentre, open, randomised controlled clinical trial. J Wound Care, 2021, 30(Suppl 5): S7-S14.
37.	Wang S, Pan LF, Gao L, et al. Randomized research on the mechanism of local oxygen therapy promoting wound healing of diabetic foot based on RNA-seq technology. Ann Palliat Med, 2021, 10(2): 973-983.
38.	He S, Liang C, Yi C, et al. Therapeutic effect of continuous diffusion of oxygen therapy combined with traditional moist wound dressing therapy in the treatment of diabetic foot ulcers. Diabetes Res Clin Pract, 2021, 174: 108743.
39.	Anirudh V, Kamath DY, Ghosh S, et al. Topical controlled warm oxygen therapy delivered through a novel device (KADAM™) to treat diabetic foot ulcers: a randomized controlled, open, pilot trial. Indian J Surg, 2021, 83(Suppl 4): S907-S914.
40.	Al-Jalodi O, Kupcella M, Breisinger K, et al. A multicenter clinical trial evaluating the durability of diabetic foot ulcer healing in ulcers treated with topical oxygen and standard of care versus standard of care alone 1 year post healing. Int Wound J, 2022, 19(7): 1838-1842.
41.	Leslie CA, Sapico FL, Ginunas VJ, et al. Randomized controlled trial of topical hyperbaric oxygen for treatment of diabetic foot ulcers. Diabetes Care, 1988, 11(2): 111-115.
42.	Martínez-Sánchez G, Al-Dalain SM, Menéndez S, et al. Therapeutic efficacy of ozone in patients with diabetic foot. Eur J Pharmacol, 2005, 523(1-3): 151-161.
43.	Izadi M, Kheirjou R, Mohammadpour R, et al. Efficacy of comprehensive ozone therapy in diabetic foot ulcer healing. Diabetes Metab Syndr, 2019, 13(1): 822-825.
44.	Wainstein J, Feldbrin Z, Boaz M, et al. Efficacy of ozone-oxygen therapy for the treatment of diabetic foot ulcers. Diabetes Technol Ther, 2011, 13(12): 1255-1260.
45.	Zhang J, Guan M, Xie C, et al. Increased growth factors play a role in wound healing promoted by noninvasive oxygen-ozone therapy in diabetic patients with foot ulcers. Oxid Med Cell Longev, 2014, 2014: 273475.
46.	牛新艳. 高压氧治疗糖尿病足30例疗效观察. 兵团医学, 2004, (3): 40.
47.	张征宇, 付顺控, 孙澍彬. 高压氧治疗糖尿病足溃疡的疗效观察. 中国基层医药, 2005, 12(8): 1054-1055.
48.	孔磊, 黄忠, 覃少清, 等. 高压氧综合治疗糖尿病足的疗效观察及护理. 护士进修杂志, 2006, 21(9): 845-847.
49.	许立民. 糖尿病足高压氧与非高压氧治疗的疗效对比观察. 内科, 2007, 2(4): 507-508.
50.	邓绍芝. 高压氧治疗糖尿病足溃疡患者的效果观察. 护理学报, 2010, 17(22): 35-37.
51.	熊雨, 郑晓秋, 陈代进. 高压氧治疗搪尿病足的相关临床研究. 医学信息(中旬刊), 2011, 24(8): 3566-3567.
52.	王华. 高压氧治疗糖尿病足的疗效研究. 四川医学, 2011, 32(8): 1232-1233.
53.	刘杰. 应用高压氧治疗糖尿病足部溃疡临床疗效观察. 中华损伤与修复杂志(电子版), 2012, 7(2): 56-57.
54.	韦华, 王民登, 李凤玲, 等. 高压氧对糖尿病足溃疡临床效果及血浆纤溶系统的影响. 重庆医学, 2012, 41(5): 480-482.
55.	庞谊, 唐晶, 陈敏, 等. 高压氧辅助治疗对糖尿病足溃疡患者血清胰岛素样生长因子-1的影响. 中国医药指南, 2012, 10(8): 11-12.
56.	李文. 高压氧综合治疗老年糖尿病足76例疗效观察. 广西医学, 2013, 35(4): 473-474.
57.	李冬梅. 高压氧治疗糖尿病足的疗效研究. 国际内分泌代谢杂志, 2014, 34(5): 356-359.
58.	祖艳红, 王娜. 高压氧治疗糖尿病足的临床观察. 医学信息, 2014, (26): 348-349.
59.	邱惠芝. 高压氧治疗对0~1级糖尿病足患者的治疗效果. 四川医学, 2015, 36(10): 1440-1443.
60.	叶洁, 魏颖丽, 陆安娜. 初期糖尿病足高压氧疗法探讨. 浙江临床医学, 2017, 19(5): 862-863.
61.	周鑫. 糖尿病足应用高压氧综合治疗的疗效分析. 按摩与康复医学, 2018, 9(19): 51-52.
62.	董颖. 高压氧治疗糖尿病足溃疡创面的护理管理及疗效观察. 糖尿病新世界, 2019, 22(21): 87-88.
63.	原霞, 王越. 高压氧综合治疗糖尿病足的效果分析. 河南医学研究, 2019, 28(21): 3857-3859.
64.	黄姚萍, 覃慧悦. 高压氧治疗糖尿病足溃疡创面的护理管理及疗效观察. 右江民族医学院学报, 2019, 41(2): 225-227.
65.	吴莉, 黄丽香, 许青芬. 高压氧辅助治疗糖尿病足部溃疡的临床疗效. 糖尿病新世界, 2020, 23(2): 191-192.
66.	刘淼, 刘友红, 张丽. 高压氧综合治疗糖尿病足的效果. 中国医药指南, 2023, 21(8): 86-88.
67.	江南, 周湘明, 王荣芬, 等. 局部氧疗治疗糖尿病足溃疡面的临床护理体会. 中国保健营养, 2019, 29(22): 193.
68.	夏威, 刘林, 夏令杰, 等. O₃气浴辅治2型糖尿病感染性足溃疡疗效观察. 山东医药, 2008, 48(10): 44-45.
69.	万丽梅, 刘革利, 杨兴月, 等. 臭氧治疗糖尿病足60例临床报道. 中外健康文摘, 2010, 7(32): 145-148.
70.	梁婵波, 黄健宁. 糖尿病感染性足溃疡的臭氧综合治疗及护理. 国际护理学杂志, 2010, 29(7): 980-982.
71.	何月莲, 甘志芹, 陈世燕, 等. 臭氧气浴综合治疗糖尿病感染性足溃疡的护理研究. 中国医药指南, 2011, 9(22): 337-338.
72.	陈世燕, 何月莲. 臭氧气浴治疗糖尿病感染性足溃疡护理观察. 医药前沿, 2012, 2(13): 214-215.
73.	张净, 薛耀明, 罗祥荣. 臭氧治疗对糖尿病足患者局部组织VEGFTGF-βPDGF表达变化的影响研究. 山西医药杂志, 2013, (20): 1100-1103.
74.	葛燕. 分析糖尿病感染性足溃疡的臭氧综合治疗以及护理方法. 糖尿病新世界, 2014, (13): 53-53.
75.	马君朝. 臭氧治疗糖尿病足临床疗效探讨. 糖尿病新世界, 2014, (9): 35-35.
76.	邓莉, 杨升平, 朱东梅, 等. 医用臭氧灌注治疗糖尿病感染性足溃疡的疗效观察. 医药前沿, 2014, (36): 248-249.
77.	王丽萍, 王利娴, 庞海艳, 等. 臭氧治疗对糖尿病足局部组织VEGF, TGF-β, PDGF表达的变化影响. 中国医药导刊, 2017, 19(5): 472-473.
78.	Sen S, Sen S. Therapeutic effects of hyperbaric oxygen: integrated review. Med Gas Res, 2021, 11(1): 30-33.
79.	Klakeel M, Kowalske K. The role of hyperbaric oxygen therapy for the treatment of wounds. Phys Med Rehabil Clin N Am, 2022, 33(4): 823-832.
80.	Benincasa JC, de Freitas Filho LH, Carneiro GD, et al. Hyperbaric oxygen affects endothelial progenitor cells proliferation in vitro. Cell Biol Int, 2019, 43(2): 136-146.
81.	Huang X, Liang P, Jiang B, et al. Hyperbaric oxygen potentiates diabetic wound healing by promoting fibroblast cell proliferation and endothelial cell angiogenesis. Life Sci, 2020, 259: 118246.
82.	De Wolde SD, Hulskes RH, Weenink RP, et al. The effects of hyperbaric oxygenation on oxidative stress, inflammation and angiogenesis. Biomolecules, 2021, 11(8): 1210.
83.	Memar MY, Yekani M, Alizadeh N, et al. Hyperbaric oxygen therapy: antimicrobial mechanisms and clinical application for infections. Biomed Pharmacother, 2019, 109: 440-447.
84.	Camporesi EM. Side effects of hyperbaric oxygen therapy. Undersea Hyperb Med, 2014, 41(3): 253-257.
85.	de Smet GHJ, Kroese LF, Menon AG, et al. Oxygen therapies and their effects on wound healing. Wound Repair Regen, 2017, 25(4): 591-608.
86.	Kaufman H, Gurevich M, Tamir E, et al. Topical oxygen therapy stimulates healing in difficult, chronic wounds: a tertiary centre experience. J Wound Care, 2018, 27(7): 426-433.

1. McDermott K, Fang M, Boulton AJM, et al. Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers. Diabetes Care, 2023, 46(1): 209-221.
2. Primadhi RA, Septrina R, Hapsari P, et al. Amputation in diabetic foot ulcer: a treatment dilemma. World J Orthop, 2023, 14(5): 312-318.
3. Chen L, Sun S, Gao Y, et al. Global mortality of diabetic foot ulcer: a systematic review and meta-analysis of observational studies. Diabetes Obes Metab, 2023, 25(1): 36-45.
4. Armstrong DG, Tan TW, Boulton AJM, et al. Diabetic foot ulcers: a review. JAMA, 2023, 330(1): 62-75.
5. Wenhui L, Changgeng F, Lei X, et al. Hyperbaric oxygen therapy for chronic diabetic foot ulcers: an overview of systematic reviews. Diabetes Res Clin Pract, 2021, 176: 108862.
6. Yellin JI, Gaebler JA, Zhou FF, et al. Reduced hospitalizations and amputations in patients with diabetic foot ulcers treated with cyclical pressurized topical wound oxygen therapy: real-world outcomes. Adv Wound Care (New Rochelle), 2022, 11(12): 657-665.
7. Astasio-Picado Á, Babiano AÁ, López-Sánchez M, et al. Use of ozone therapy in diabetic foot ulcers. J Pers Med, 2023, 13(10): 1439.
8. Kwee E, Borgdorff M, Schepers T, et al. Adjunctive hyperbaric oxygen therapy in the management of severe lower limb soft tissue injuries: a systematic review. Eur J Trauma Emerg Surg, 2024, 50(3): 1093-1100.
9. Frykberg R, Andersen C, Chadwick P, et al. Use of topical oxygen therapy in wound healing. J Wound Care, 2023, 32(Sup8b): S1-S32.
10. Kushmakov R, Gandhi J, Seyam O, et al. Ozone therapy for diabetic foot. Med Gas Res, 2018, 8(3): 111-115.
11. Chen P, Vilorio NC, Dhatariya K, et al. Guidelines on interventions to enhance healing of foot ulcers in people with diabetes (IWGDF 2023 update). Diabetes Metab Res Rev, 2024, 40(3): e3644.
12. ElSayed NA, Aleppo G, Aroda VR, et al. 2. Classification and diagnosis of diabetes: standards of care in diabetes-2023. Diabetes Care, 2023, 46(Suppl 1): S19-S40.
13. van Netten JJ, Bus SA, Apelqvist J, et al. Definitions and criteria for diabetes-related foot disease (IWGDF 2023 update). Diabetes Metab Res Rev, 2024, 40(3): e3654.
14. Shim SR, Kim SJ, Lee J, et al. Network meta-analysis: application and practice using R software. Epidemiol Health, 2019, 41: e2019013.
15. Mbuagbaw L, Rochwerg B, Jaeschke R, et al. Approaches to interpreting and choosing the best treatments in network meta-analyses. Syst Rev, 2017, 6(1): 79.
16. Higgins JPT, Thomas J, Chandler J, et al. Cochrane handbook for systematic reviews of interventions version 6.4 (updated August 2023). Cochrane, 2023.
17. Doctor N, Pandya S, Supe A. Hyperbaric oxygen therapy in diabetic foot. J Postgrad Med, 1992, 38(3): 112-114.
18. Faglia E, Favales F, Aldeghi A, et al. Adjunctive systemic hyperbaric oxygen therapy in treatment of severe prevalently ischemic diabetic foot ulcer: a randomized study. Diabetes Care, 1996, 19(12): 1338-1343.
19. Abidia A, Laden G, Kuhan G, et al. The role of hyperbaric oxygen therapy in ischaemic diabetic lower extremity ulcers: a double-blind randomised-controlled trial. Eur J Vasc Endovasc Surg, 2003, 25(6): 513-518.
20. Kessler L, Bilbault P, Ortéga F, et al. Hyperbaric oxygenation accelerates the healing rate of nonischemic chronic diabetic foot ulcers: a prospective randomized study. Diabetes Care, 2003, 26(8): 2378-2382.
21. Duzgun AP, Satir HZ, Ozozan O, et al. Effect of hyperbaric oxygen therapy on healing of diabetic foot ulcers. J Foot Ankle Surg, 2008, 47(6): 515-519.
22. Löndahl M, Katzman P, Nilsson A, et al. Hyperbaric oxygen therapy facilitates healing of chronic foot ulcers in patients with diabetes. Diabetes Care, 2010, 33(5): 998-1003.
23. Ma L, Li P, Shi Z, et al. A prospective, randomized, controlled study of hyperbaric oxygen therapy: effects on healing and oxidative stress of ulcer tissue in patients with a diabetic foot ulcer. Ostomy Wound Manage, 2013, 59(3): 18-24.
24. Fedorko L, Bowen JM, Jones W, et al. Hyperbaric oxygen therapy does not reduce indications for amputation in patients with diabetes with nonhealing ulcers of the lower limb: a prospective, double-blind, randomized controlled clinical trial. Diabetes Care, 2016, 39(3): 392-399.
25. Chen CY, Wu RW, Hsu MC, et al. Adjunctive hyperbaric oxygen therapy for healing of chronic diabetic foot ulcers: a randomized controlled trial. J Wound Ostomy Continence Nurs, 2017, 44(6): 536-545.
26. Santema KTB, Stoekenbroek RM, Koelemay MJW, et al. Hyperbaric oxygen therapy in the treatment of ischemic lower- extremity ulcers in patients with diabetes: results of the DAMO2CLES multicenter randomized clinical trial. Diabetes Care, 2018, 41(1): 112-119.
27. Perren S, Gatt A, Papanas N, et al. Hyperbaric oxygen therapy in ischaemic foot ulcers in type 2 diabetes: a clinical trial. Open Cardiovasc Med J, 2018, 12: 80-85.
28. Dhamodharan U, Karan A, Sireesh D, et al. Tissue-specific role of Nrf2 in the treatment of diabetic foot ulcers during hyperbaric oxygen therapy. Free Radic Biol Med, 2019, 138: 53-62.
29. Salama SE, Eldeeb AE, Elbarbary AH, et al. Adjuvant hyperbaric oxygen therapy enhances healing of nonischemic diabetic foot ulcers compared with standard wound care alone. Int J Low Extrem Wounds, 2019, 18(1): 75-80.
30. Kumar A, Shukla U, Prabhakar T, et al. Hyperbaric oxygen therapy as an adjuvant to standard therapy in the treatment of diabetic foot ulcers. J Anaesthesiol Clin Pharmacol, 2020, 36(2): 213-218.
31. Wadee AN, Fahmy SM, El-Deen HAB. Low-level laser therapy (photobiomodulation) versus hyperbaric oxygen therapy on healing of chronic diabetic foot ulcers: a controlled randomized trial. Phys Ther Rev, 2021, 26: 73-80.
32. Yu J, Lu S, McLaren AM, et al. Topical oxygen therapy results in complete wound healing in diabetic foot ulcers. Wound Repair Regen, 2016, 24(6): 1066-1072.
33. Driver VR, Reyzelman A, Kawalec J, et al. A prospective, randomized, blinded, controlled trial comparing transdermal continuous oxygen delivery to moist wound therapy for the treatment of diabetic foot ulcers. Ostomy Wound Manage, 2017, 63(4): 12-28.
34. Niederauer MQ, Michalek JE, Liu Q, et al. Continuous diffusion of oxygen improves diabetic foot ulcer healing when compared with a placebo control: a randomised, double-blind, multicentre study. J Wound Care, 2018, 27(Sup9): S30-S45.
35. Frykberg RG, Franks PJ, Edmonds M, et al. A multinational, multicenter, randomized, double-blinded, placebo-controlled trial to evaluate the efficacy of cyclical topical wound oxygen (TWO2) therapy in the treatment of chronic diabetic foot ulcers: the TWO2 study. Diabetes Care, 2020, 43(3): 616-624.
36. Serena TE, Bullock NM, Cole W, et al. Topical oxygen therapy in the treatment of diabetic foot ulcers: a multicentre, open, randomised controlled clinical trial. J Wound Care, 2021, 30(Suppl 5): S7-S14.
37. Wang S, Pan LF, Gao L, et al. Randomized research on the mechanism of local oxygen therapy promoting wound healing of diabetic foot based on RNA-seq technology. Ann Palliat Med, 2021, 10(2): 973-983.
38. He S, Liang C, Yi C, et al. Therapeutic effect of continuous diffusion of oxygen therapy combined with traditional moist wound dressing therapy in the treatment of diabetic foot ulcers. Diabetes Res Clin Pract, 2021, 174: 108743.
39. Anirudh V, Kamath DY, Ghosh S, et al. Topical controlled warm oxygen therapy delivered through a novel device (KADAM™) to treat diabetic foot ulcers: a randomized controlled, open, pilot trial. Indian J Surg, 2021, 83(Suppl 4): S907-S914.
40. Al-Jalodi O, Kupcella M, Breisinger K, et al. A multicenter clinical trial evaluating the durability of diabetic foot ulcer healing in ulcers treated with topical oxygen and standard of care versus standard of care alone 1 year post healing. Int Wound J, 2022, 19(7): 1838-1842.
41. Leslie CA, Sapico FL, Ginunas VJ, et al. Randomized controlled trial of topical hyperbaric oxygen for treatment of diabetic foot ulcers. Diabetes Care, 1988, 11(2): 111-115.
42. Martínez-Sánchez G, Al-Dalain SM, Menéndez S, et al. Therapeutic efficacy of ozone in patients with diabetic foot. Eur J Pharmacol, 2005, 523(1-3): 151-161.
43. Izadi M, Kheirjou R, Mohammadpour R, et al. Efficacy of comprehensive ozone therapy in diabetic foot ulcer healing. Diabetes Metab Syndr, 2019, 13(1): 822-825.
44. Wainstein J, Feldbrin Z, Boaz M, et al. Efficacy of ozone-oxygen therapy for the treatment of diabetic foot ulcers. Diabetes Technol Ther, 2011, 13(12): 1255-1260.
45. Zhang J, Guan M, Xie C, et al. Increased growth factors play a role in wound healing promoted by noninvasive oxygen-ozone therapy in diabetic patients with foot ulcers. Oxid Med Cell Longev, 2014, 2014: 273475.
46. 牛新艳. 高压氧治疗糖尿病足30例疗效观察. 兵团医学, 2004, (3): 40.
47. 张征宇, 付顺控, 孙澍彬. 高压氧治疗糖尿病足溃疡的疗效观察. 中国基层医药, 2005, 12(8): 1054-1055.
48. 孔磊, 黄忠, 覃少清, 等. 高压氧综合治疗糖尿病足的疗效观察及护理. 护士进修杂志, 2006, 21(9): 845-847.
49. 许立民. 糖尿病足高压氧与非高压氧治疗的疗效对比观察. 内科, 2007, 2(4): 507-508.
50. 邓绍芝. 高压氧治疗糖尿病足溃疡患者的效果观察. 护理学报, 2010, 17(22): 35-37.
51. 熊雨, 郑晓秋, 陈代进. 高压氧治疗搪尿病足的相关临床研究. 医学信息(中旬刊), 2011, 24(8): 3566-3567.
52. 王华. 高压氧治疗糖尿病足的疗效研究. 四川医学, 2011, 32(8): 1232-1233.
53. 刘杰. 应用高压氧治疗糖尿病足部溃疡临床疗效观察. 中华损伤与修复杂志(电子版), 2012, 7(2): 56-57.
54. 韦华, 王民登, 李凤玲, 等. 高压氧对糖尿病足溃疡临床效果及血浆纤溶系统的影响. 重庆医学, 2012, 41(5): 480-482.
55. 庞谊, 唐晶, 陈敏, 等. 高压氧辅助治疗对糖尿病足溃疡患者血清胰岛素样生长因子-1的影响. 中国医药指南, 2012, 10(8): 11-12.
56. 李文. 高压氧综合治疗老年糖尿病足76例疗效观察. 广西医学, 2013, 35(4): 473-474.
57. 李冬梅. 高压氧治疗糖尿病足的疗效研究. 国际内分泌代谢杂志, 2014, 34(5): 356-359.
58. 祖艳红, 王娜. 高压氧治疗糖尿病足的临床观察. 医学信息, 2014, (26): 348-349.
59. 邱惠芝. 高压氧治疗对0~1级糖尿病足患者的治疗效果. 四川医学, 2015, 36(10): 1440-1443.
60. 叶洁, 魏颖丽, 陆安娜. 初期糖尿病足高压氧疗法探讨. 浙江临床医学, 2017, 19(5): 862-863.
61. 周鑫. 糖尿病足应用高压氧综合治疗的疗效分析. 按摩与康复医学, 2018, 9(19): 51-52.
62. 董颖. 高压氧治疗糖尿病足溃疡创面的护理管理及疗效观察. 糖尿病新世界, 2019, 22(21): 87-88.
63. 原霞, 王越. 高压氧综合治疗糖尿病足的效果分析. 河南医学研究, 2019, 28(21): 3857-3859.
64. 黄姚萍, 覃慧悦. 高压氧治疗糖尿病足溃疡创面的护理管理及疗效观察. 右江民族医学院学报, 2019, 41(2): 225-227.
65. 吴莉, 黄丽香, 许青芬. 高压氧辅助治疗糖尿病足部溃疡的临床疗效. 糖尿病新世界, 2020, 23(2): 191-192.
66. 刘淼, 刘友红, 张丽. 高压氧综合治疗糖尿病足的效果. 中国医药指南, 2023, 21(8): 86-88.
67. 江南, 周湘明, 王荣芬, 等. 局部氧疗治疗糖尿病足溃疡面的临床护理体会. 中国保健营养, 2019, 29(22): 193.
68. 夏威, 刘林, 夏令杰, 等. O₃气浴辅治2型糖尿病感染性足溃疡疗效观察. 山东医药, 2008, 48(10): 44-45.
69. 万丽梅, 刘革利, 杨兴月, 等. 臭氧治疗糖尿病足60例临床报道. 中外健康文摘, 2010, 7(32): 145-148.
70. 梁婵波, 黄健宁. 糖尿病感染性足溃疡的臭氧综合治疗及护理. 国际护理学杂志, 2010, 29(7): 980-982.
71. 何月莲, 甘志芹, 陈世燕, 等. 臭氧气浴综合治疗糖尿病感染性足溃疡的护理研究. 中国医药指南, 2011, 9(22): 337-338.
72. 陈世燕, 何月莲. 臭氧气浴治疗糖尿病感染性足溃疡护理观察. 医药前沿, 2012, 2(13): 214-215.
73. 张净, 薛耀明, 罗祥荣. 臭氧治疗对糖尿病足患者局部组织VEGFTGF-βPDGF表达变化的影响研究. 山西医药杂志, 2013, (20): 1100-1103.
74. 葛燕. 分析糖尿病感染性足溃疡的臭氧综合治疗以及护理方法. 糖尿病新世界, 2014, (13): 53-53.
75. 马君朝. 臭氧治疗糖尿病足临床疗效探讨. 糖尿病新世界, 2014, (9): 35-35.
76. 邓莉, 杨升平, 朱东梅, 等. 医用臭氧灌注治疗糖尿病感染性足溃疡的疗效观察. 医药前沿, 2014, (36): 248-249.
77. 王丽萍, 王利娴, 庞海艳, 等. 臭氧治疗对糖尿病足局部组织VEGF, TGF-β, PDGF表达的变化影响. 中国医药导刊, 2017, 19(5): 472-473.
78. Sen S, Sen S. Therapeutic effects of hyperbaric oxygen: integrated review. Med Gas Res, 2021, 11(1): 30-33.
79. Klakeel M, Kowalske K. The role of hyperbaric oxygen therapy for the treatment of wounds. Phys Med Rehabil Clin N Am, 2022, 33(4): 823-832.
80. Benincasa JC, de Freitas Filho LH, Carneiro GD, et al. Hyperbaric oxygen affects endothelial progenitor cells proliferation in vitro. Cell Biol Int, 2019, 43(2): 136-146.
81. Huang X, Liang P, Jiang B, et al. Hyperbaric oxygen potentiates diabetic wound healing by promoting fibroblast cell proliferation and endothelial cell angiogenesis. Life Sci, 2020, 259: 118246.
82. De Wolde SD, Hulskes RH, Weenink RP, et al. The effects of hyperbaric oxygenation on oxidative stress, inflammation and angiogenesis. Biomolecules, 2021, 11(8): 1210.
83. Memar MY, Yekani M, Alizadeh N, et al. Hyperbaric oxygen therapy: antimicrobial mechanisms and clinical application for infections. Biomed Pharmacother, 2019, 109: 440-447.
84. Camporesi EM. Side effects of hyperbaric oxygen therapy. Undersea Hyperb Med, 2014, 41(3): 253-257.
85. de Smet GHJ, Kroese LF, Menon AG, et al. Oxygen therapies and their effects on wound healing. Wound Repair Regen, 2017, 25(4): 591-608.
86. Kaufman H, Gurevich M, Tamir E, et al. Topical oxygen therapy stimulates healing in difficult, chronic wounds: a tertiary centre experience. J Wound Care, 2018, 27(7): 426-433.

Chinese Journal of Evidence-Based Medicine

Latest ArticlesEfficacy of oxygen therapy for diabetic foot ulcers: a network meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Format

Content