{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T11:11:13Z","timestamp":1790334673984,"version":"4.1.0"},"reference-count":68,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Diabetic foot ulcers are an important cause of morbidity, amputation, disability and healthcare expenditure in sub\u2010Saharan Africa, where limitations in preventive foot care, referral pathways, vascular services, multidisciplinary wound care and financial protection may contribute to poor outcomes. This critical narrative review evaluates the potential role of systemic hyperbaric oxygen therapy as an adjunct to standard diabetic foot ulcer care in sub\u2010Saharan Africa by integrating evidence on clinical effectiveness and safety with health\u2010system, economic, equity and implementation considerations. Evidence was drawn from clinical studies, systematic reviews, clinical guidelines, economic evaluations and literature relevant to diabetic foot care and health\u2010system capacity in the region. Global evidence suggests that systemic hyperbaric oxygen therapy may improve wound healing in selected patients whose ulcers fail to heal with best standard care, but findings remain heterogeneous; evidence for reducing amputation is uncertain, and direct regional evidence is sparse. Implementation in sub\u2010Saharan Africa would require reliable oxygen, electricity, trained staff, safe maintenance systems, multidisciplinary care, referral pathways, sustainable financing and feasible treatment completion. The therapy should therefore not be considered routine or first\u2010line treatment. Where appropriate infrastructure exists, carefully monitored referral\u2010centre pilots should assess clinical outcomes, safety, treatment completion, affordability, budget impact and equity before wider implementation.<\/jats:p>","DOI":"10.1111\/iwj.71027","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:04:59Z","timestamp":1788311099000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hyperbaric Oxygen Therapy for Diabetic Foot Ulcers in Sub\u2010Saharan Africa: A Critical Review of Clinical Evidence, Health\u2010System Feasibility and Public Health Implications"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3086-6369","authenticated-orcid":false,"given":"Matthew Chibunna","family":"Igwe","sequence":"first","affiliation":[{"name":"Department of Public Health, School of Allied Health Sciences Kampala International University, Western Campus  Ishaka Uganda"},{"name":"Department of Medical Laboratory Science, Faculty of Allied Health Sciences Enugu State University of Science and Technology  Enugu Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4105-8615","authenticated-orcid":false,"given":"Esther Ugo","family":"Alum","sequence":"additional","affiliation":[{"name":"Department of Research and Publications Kampala International University  Kampala Uganda"},{"name":"Department of Biochemistry, Faculty of Science Ebonyi State University  Abakaliki Ebonyi State Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6024-2608","authenticated-orcid":false,"given":"Alphonsus Ogbonna","family":"Ogbuabor","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Science, Faculty of Allied Health Sciences Enugu State University of Science and Technology  Enugu Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibala Ibor","family":"Oboma","sequence":"additional","affiliation":[{"name":"Pathology Department, School of Medicine and Allied Health Sciences Mwanza University  Mwanza Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2049-8315","authenticated-orcid":false,"given":"Onyinyechi","family":"Bede\u2010Ojimadu","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Science, School of Allied Health Sciences Kampala International University, Western Campus  Ishaka Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8736-3482","authenticated-orcid":false,"given":"Charles Iyore","family":"Idehen","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Science, School of Allied Health Sciences Kampala International University, Western Campus  Ishaka Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_2_17_2_1","doi-asserted-by":"publisher","DOI":"10.4239\/wjd.v13.i12.1106"},{"key":"e_1_2_17_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20108587(17)30181\u2010X"},{"key":"e_1_2_17_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcmm.70310"},{"key":"e_1_2_17_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201081886\u20101"},{"issue":"3","key":"e_1_2_17_6_1","first-page":"205","article-title":"A Clinical Practice Guideline for the Use of Hyperbaric Oxygen Therapy in the Treatment of Diabetic Foot Ulcers","volume":"42","author":"Huang E. 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