Diabetic ulcers are chronic, complex, or problem wounds of the legs and feet in people with diabetes.

Diabetic ulcers that fail to heal in three months are usually considered chronic.

Some take years to heal or never do.


Diabetic ulcers require a healthy, oxygenated wound bed to heal.

A lack of sufficient oxygen (hypoxia) in the wound bed slows or stops the normal healing process.

Wound healing in people with diabetes is often complicated by poor blood circulation in the feet and legs.

Nerve disease (neuropathy) may also cause a loss of sensation in the feet and legs, so even a small cut, sore, or pressure ulcer may go unnoticed for some time and develop into a problem wound.

Diabetic ulcers are especially prone to serious bacterial infections that threaten life and limb.

Cases presentation

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Treatment with Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) is an effective adjunct to traditional wound care therapies, including topical cleaning; surgical removal (debridement) of dead skin and tissue; application of dressings, ointments, and biologics; and use of compression boots or stockings, vacuum or negative pressure wound therapy (NPWT) pumps, ultrasound, laser, and other emerging technologies.

HBOT helps repair wounds and enhance healing by improving blood circulation, encouraging the formation of new capillary blood vessels (angiogenesis), supplying more oxygen to tissue in the wound bed, and stimulating the growth and distribution of stem cells.

Hyperbaric oxygen also helps kill the anaerobic bacteria that cause some of the worst infections in chronic wounds.

Evidence for HBOT is especially strong in diabetic foot ulcers classified Wagner Grade 3 or higher, for which hyperbaric oxygen is widely considered standard therapy.

Undersea and Hyperbaric Medical Society

Mechanisms of HBO2

For more information please read the use of Hyperbaric oxygen therapy in   Chronic Wounds


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