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Treatment of diabetic foot ulcers: A comparative study of extracorporeal shockwave therapy and hyperbaric oxygen therapy

Ching-Jen CJ Wang, Re-Wen RW Wu, and Ya-Ju YJ Yang

Diabetes Res Clin Pract 92(2):7 (2011) PMID 21310502

Objective: This study compared the effectiveness of extracorporeal shockwave therapy (ESWT) and hyperbaric oxygen therapy (HBOT) in chronic diabetic foot ulcers. Patients and methods: The ESWT group (39 patients/44 feet) received shockwave therapy twice per week for total six treatments. The HBOT group (38 patients/40 feet) received hyperbaric oxygen therapy daily for total 20 treatments. Evaluations included clinical assessment, blood flow perfusion scan and histopathological examination. Results: The overall clinical results showed completely healed ulcers in 57% and 25% (P=0.003); >=50% improved ulcers in 32% and 15% (P=0.071); unchanged ulcers in 11% and 60% (P<0.001) and none worsened for the ESWT and the HBOT group respectively. The blood flow perfusion rates were comparable between the two groups before treatment (P=0.245), however, significant differences were noted after treatment favoring the ESWT group (P=0.002). Histopathological examination revealed considerable increases in cell proliferation and decreases in cell apoptosis in the ESWT group as compared to the HBOT group. Conclusion: ESWT is more effective than HBOT in chronic diabetic foot ulcers. ESWT-treated ulcers showed significant improvement in blood flow perfusion rate and cell activity leading to better healing of the ulcers relative to HBOT in chronic diabetic foot ulcers.

Copyright © 2011 Elsevier Ltd. All rights reserved.

DOI: 10.1016/j.diabres.2011.01.019
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