Hyperbaric oxygen therapy in the healing process of foot ulcers in diabetic type 2 patients marked by interleukin 6, vascular endothelial growth factor, and PEDIS score: A randomized controlled trial study

Introduction: Diabetic foot ulcers (DFU) is a major social issue in terms of treatment cost. DFU has a high risk of infection with morbidity and an increased risk of lower-extremity amputations. Currently, there are no satisfactory treatments for DFU. This motivates a search for methods that can stimulate the ac- celeration of wound healing; one of these methods is the use of hyperbaric oxygen therapy (HBOT). This study attempts to prove the ability of HBOT to accelerate the healing process of DFU by increasing levels of both serum Interleukin 6 (IL-6) and Vascular Endothelial Growth Factor (VEFG), assessed by the perfusion, extent, depth, infection and sensation (PEDIS) score. Methods: Twenty DFU patients were divided into two groups. The control group underwent a holistic DFU treatment without HBOT and was tested twice for serum IL-6 and VEGF levels, 1 day apart. The HBOT group underwent a holistic DFU treatment with HBOT and was also tested twice for serum IL-6 and VEGF levels: one day before HBOT and 2 h after the first day of HBOT. Results: The changes in serum IL-6 and VEGF levels were greater in patients with HBOT than in control patients (p 1⁄4 0.025 and p 1⁄4 0.004). As for PEDIS score assessment, the HBOT group had significantly lower PEDIS scores than the control group (p < 0.001). Conclusion: HBOT can help accelerate the wound healing process, which was proven by increased serum IL-6 and VEGF levels and a lower PEDIS score.