{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T18:50:07Z","timestamp":1793559007241,"version":"4.5.0"},"reference-count":41,"publisher":"Mark Allen Group","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wound Care"],"published-print":{"date-parts":[[2021,9,2]]},"abstract":"<jats:sec><jats:title>Aim:<\/jats:title><jats:p>Hard-to-heal diabetic foot ulcers (DFUs) may increase the risk of amputation. This study reports the positive influence of hyperbaric oxygen therapy (HBOT) on hard-to-heal DFUs involving underlying bone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method:<\/jats:title><jats:p>A single-centre, retrospective cohort study reporting the results of HBOT and wound care on hard-to-heal University of Texas grade 3 DFUs (i.e., involving underlying bone) between 2013 and 2019. Outcome measures were primarily (near-) complete wound healing (i.e., \u226580% ulcer surface area reduction) and amputation rate (minor or major), and secondarily the number of hyperbaric sessions and improvement in quality of life (QoL) and pain score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>The study included 206 patients, of whom 74 (36%) achieved complete wound healing, and 75 (36%) near-complete healing. Amputations were performed in 27 patients (13%): 12 (6%) minor and 15 (7%) major. The median number of HBOT sessions was 42. Participants who achieved complete healing received a median of 43 sessions, compared with 10 for those who required major amputation. Patients with at least 30 sessions were less likely to undergo amputation (odds ratio: 0.08; 95% confidence interval (CI): 0.03\u20130.21). Mean QoL increased by 7.6 points (95%CI: 3.9\u201311.3; p&lt;0.01) and median pain score fell from 3 to 1 (0\u20133) (p&lt;0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>The addition of HBOT to standard wound care may lead to a decreased amputation risk, improved wound healing and increased QoL for people with a University of Texas grade 3 DFU. An adequate number of HBOT sessions is required to achieve optimal clinical results. Objective selection criteria and shared decision-making are suggested to improve dropout rates.<\/jats:p><\/jats:sec>","DOI":"10.12968\/jowc.2021.30.9.722","type":"journal-article","created":{"date-parts":[[2021,9,23]],"date-time":"2021-09-23T19:27:01Z","timestamp":1632425221000},"page":"722-728","source":"Crossref","is-referenced-by-count":4,"title":["Hyperbaric oxygen treatment for University of Texas grade 3 diabetic foot ulcers: a retrospective cohort study"],"prefix":"10.12968","volume":"30","author":[{"given":"Rutger C","family":"Lalieu","sequence":"first","affiliation":[{"name":"Hyperbaar Geneeskundig Centrum, Rijswijk, the Netherlands"},{"name":"Amsterdam University Medical Centers, Department of Anesthesiology, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem","family":"Mulder","sequence":"additional","affiliation":[{"name":"Hyperbaar Geneeskundig Centrum, Rijswijk, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9 D Bol","family":"Raap","sequence":"additional","affiliation":[{"name":"Hyperbaar Geneeskundig Centrum, Rijswijk, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia","family":"Stolk","sequence":"additional","affiliation":[{"name":"Hyperbaar Geneeskundig Centrum, Rijswijk, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casper","family":"Smit","sequence":"additional","affiliation":[{"name":"Hyperbaar Geneeskundig Centrum, Rijswijk, the Netherlands"},{"name":"Reinier de Graaf Gasthuis, Department of Surgery, Delft, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emile FL","family":"Dubois","sequence":"additional","affiliation":[{"name":"Hyperbaar Geneeskundig Centrum, Rijswijk, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob A","family":"van Hulst","sequence":"additional","affiliation":[{"name":"Amsterdam University Medical Centers, Department of Anesthesiology, Amsterdam, the Netherlands"},{"name":"Amsterdam University Medical Centers, Department of Surgery, Hyperbaric Dept, Amsterdam, the Netherland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5130","reference":[{"issue":"24","key":"B2","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1056\/NEJMra1615439","volume":"376","author":"Armstrong DG","year":"2017","journal-title":"N Engl J Med"},{"issue":"2","key":"B3","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1046\/j.1464-5491.2001.00422.x","volume":"18","author":"Oyibo SO","year":"2001","journal-title":"Diabet Med"},{"issue":"3","key":"B4","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1007\/s00125-008-1226-2","volume":"52","author":"Gershater MA","year":"2009","journal-title":"Diabetologia"},{"issue":"4","key":"B5","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1111\/j.1742-481X.2007.00392.x","volume":"4","author":"Armstrong DG","year":"2007","journal-title":"Int Wound J"},{"issue":"9498","key":"B6","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1016\/S0140-6736(05)67698-2","volume":"366","author":"Boulton AJ","year":"2005","journal-title":"Lancet"},{"issue":"8","key":"B7","doi-asserted-by":"crossref","first-page":"e0182081","DOI":"10.1371\/journal.pone.0182081","volume":"12","author":"Narres M","year":"2017","journal-title":"PLoS One"},{"issue":"6","key":"B8","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1016\/S1067-2516(96)80125-6","volume":"35","author":"Lavery LA","year":"1996","journal-title":"J Foot Ankle Surg"},{"issue":"5","key":"B9","doi-asserted-by":"crossref","first-page":"855","DOI":"10.2337\/diacare.21.5.855","volume":"21","author":"Armstrong DG","year":"1998","journal-title":"Diabetes Care"},{"issue":"2","key":"B10","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/j.1365-2133.2010.09804.x","volume":"163","author":"Schreml S","year":"2010","journal-title":"Br J Dermatol"},{"key":"B11","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/B978-1-4160-3406-3.50016-0","volume-title":"Physiology and medicine of hyperbaric oxygen therapy","author":"Hopf HW","year":"2008"},{"issue":"4","key":"B12","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/01.ASW.0000513089.75457.22","volume":"30","author":"Lam G","year":"2017","journal-title":"Adv Skin Wound Care"},{"issue":"6","key":"B13","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1111\/wrr.12480","volume":"24","author":"Andre-Levigne D","year":"2016","journal-title":"Wound Repair Regen"},{"key":"B14","unstructured":"Moon RE; for the Undersea and Hyperbaric Medical Society. 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