{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:11:50Z","timestamp":1791598310763,"version":"4.3.4"},"reference-count":24,"publisher":"American Diabetes Association","issue":"1","license":[{"start":{"date-parts":[[2017,12,20]],"date-time":"2017-12-20T00:00:00Z","timestamp":1513728000000},"content-version":"vor","delay-in-days":55,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["83700.2005"],"award-info":[{"award-number":["83700.2005"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Conflicting evidence exists on the effects of hyperbaric oxygen therapy (HBOT) in the treatment of chronic ischemic leg ulcers. The aim of this trial was to investigate whether additional HBOT would benefit patients with diabetes and ischemic leg ulcers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>Patients with diabetes with an ischemic wound (n = 120) were randomized to standard care (SC) without or with HBOT (SC+HBOT). Primary outcomes were limb salvage and wound healing after 12 months, as well as time to wound healing. Other end points were amputation-free survival (AFS) and mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Both groups contained 60 patients. Limb salvage was achieved in 47 patients in the SC group vs. 53 patients in the SC+HBOT group (risk difference [RD] 10% [95% CI \u22124 to 23]). After 12 months, 28 index wounds were healed in the SC group vs. 30 in the SC+HBOT group (RD 3% [95% CI \u221214 to 21]). AFS was achieved in 41 patients in the SC group and 49 patients in the SC+HBOT group (RD 13% [95% CI \u22122 to 28]). In the SC+HBOT group, 21 patients (35%) were unable to complete the HBOT protocol as planned. Those who did had significantly fewer major amputations and higher AFS (RD for AFS 26% [95% CI 10\u201338]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Additional HBOT did not significantly improve complete wound healing or limb salvage in patients with diabetes and lower-limb ischemia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc17-0654","type":"journal-article","created":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T00:20:11Z","timestamp":1509063611000},"page":"112-119","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":148,"title":["Hyperbaric Oxygen Therapy in the Treatment of Ischemic Lower- Extremity Ulcers in Patients With Diabetes: Results of the DAMO2CLES Multicenter Randomized Clinical Trial"],"prefix":"10.2337","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3388-248X","authenticated-orcid":false,"given":"Katrien T.B.","family":"Santema","sequence":"first","affiliation":[{"name":"Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Stoekenbroek","sequence":"additional","affiliation":[{"name":"Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J.W.","family":"Koelemay","sequence":"additional","affiliation":[{"name":"Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim A.","family":"Reekers","sequence":"additional","affiliation":[{"name":"Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura M.C.","family":"van Dortmont","sequence":"additional","affiliation":[{"name":"Department of Surgery, Vlietland Hospital, Schiedam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arno","family":"Oomen","sequence":"additional","affiliation":[{"name":"Department of Surgery, St. Anna Hospital, Geldrop, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luuk","family":"Smeets","sequence":"additional","affiliation":[{"name":"Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan J.","family":"Wever","sequence":"additional","affiliation":[{"name":"Department of Surgery, Haga Hospital, Den Haag, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dink A.","family":"Legemate","sequence":"additional","affiliation":[{"name":"Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk T.","family":"Ubbink","sequence":"additional","affiliation":[{"name":"Department of Surgery, Academic Medical Center, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"DAMO2CLES Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Reichart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Balm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.E.","family":"Bodegom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.L.","family":"van Wanroij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"ten Raa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.C.","family":"Willems","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Klemm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.G.","family":"de Valk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.J.","family":"Wever","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Hulst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.C.A.","family":"de Mol van Otterloo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.A.","family":"Lenselink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.W.F.","family":"Vos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.C.","family":"van Nieuwenhuizen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.C.","family":"Vahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Smeets","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Nio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.C.H.","family":"van den Heuvel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Oomen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Swinkels","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.W.H.E.","family":"Vriens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.P.A.","family":"van Hees","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.P.","family":"van Brussel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.A.","family":"Koedam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Buijk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Lauwers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.M.C.","family":"van Dortmont","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.H.","family":"Nederhoed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.K.","family":"Kievit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.M.","family":"Wiersema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.P.","family":"Vierhout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.G.","family":"van Baal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.A.","family":"van Hulst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Groot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.A.M.","family":"Everts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.D. Bol","family":"Raap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Boonstra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. G.","family":"Monsieurs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.P. van Rees","family":"Vellinga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.H.","family":"Zwinderman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.F.","family":"Hamming","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.J.G.","family":"Peters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2017,10,26]]},"reference":[{"key":"2022031301253315200_B1"},{"key":"2022031301253315200_B2"},{"key":"2022031301253315200_B3","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1002\/dmrr.833","article-title":"The diabetic foot: grand overview, epidemiology and pathogenesis","volume":"24","author":"Boulton","year":"2008","journal-title":"Diabetes Metab Res Rev"},{"key":"2022031301253315200_B4","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1016\/j.mcna.2013.03.007","article-title":"The pathway to foot ulceration in diabetes","volume":"97","author":"Boulton","year":"2013","journal-title":"Med Clin North Am"},{"key":"2022031301253315200_B5","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1002\/dmrr.2695","article-title":"Prevention and management of foot problems in diabetes: a summary guidance for daily practice 2015, based on the IWGDF guidance documents","volume":"32","author":"Schaper","year":"2016","journal-title":"Diabetes Metab Res Rev"},{"key":"2022031301253315200_B6","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1016\/S0140-6736(05)67698-2","article-title":"The global burden of diabetic foot disease","volume":"366","author":"Boulton","year":"2005","journal-title":"Lancet"},{"key":"2022031301253315200_B7","doi-asserted-by":"crossref","first-page":"1906","DOI":"10.1007\/s00125-005-1856-6","article-title":"Health-related quality of life of diabetic foot ulcer patients and their caregivers","volume":"48","author":"Nabuurs-Franssen","year":"2005","journal-title":"Diabetologia"},{"key":"2022031301253315200_B8","doi-asserted-by":"crossref","first-page":"491","DOI":"10.2337\/diacare.26.2.491","article-title":"Amputation and mortality in new-onset diabetic foot ulcers stratified by etiology","volume":"26","author":"Moulik","year":"2003","journal-title":"Diabetes Care"},{"key":"2022031301253315200_B9","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S1262-3636(07)70193-3","article-title":"Quality of life and clinical correlates in patients with diabetic foot ulcers","volume":"31","author":"Valensi","year":"2005","journal-title":"Diabetes Metab"},{"key":"2022031301253315200_B10","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1002\/dmrr.2249","article-title":"A systematic review of the effectiveness of revascularization of the ulcerated foot in patients with diabetes and peripheral arterial disease","volume":"28","author":"Hinchliffe","year":"2012","journal-title":"Diabetes Metab Res Rev"},{"key":"2022031301253315200_B11","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1016\/j.mehy.2008.06.016","article-title":"The effect of hyperbaric oxygen therapy on blood vessel function in diabetes mellitus","volume":"71","author":"Unfirer","year":"2008","journal-title":"Med Hypotheses"},{"key":"2022031301253315200_B12","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.1007\/s11538-010-9514-7","article-title":"Mathematical model of hyperbaric oxygen therapy applied to chronic diabetic wounds","volume":"72","author":"Flegg","year":"2010","journal-title":"Bull Math Biol"},{"key":"2022031301253315200_B13","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1111\/j.1524-475X.2008.00372.x","article-title":"The use of hyperbaric oxygen therapy to treat chronic wounds: a review","volume":"16","author":"Thackham","year":"2008","journal-title":"Wound Repair Regen"},{"key":"2022031301253315200_B14","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.ejvs.2014.03.005","article-title":"Hyperbaric oxygen for the treatment of diabetic foot ulcers: a systematic review","volume":"47","author":"Stoekenbroek","year":"2014","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2022031301253315200_B15"},{"key":"2022031301253315200_B16","first-page":"CD004123","article-title":"Hyperbaric oxygen therapy for chronic wounds","volume":"6","author":"Kranke","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"2022031301253315200_B17","doi-asserted-by":"crossref","first-page":"c332","DOI":"10.1136\/bmj.c332","article-title":"CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials","volume":"340","author":"Schulz","year":"2010","journal-title":"BMJ"},{"key":"2022031301253315200_B18","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1111\/1753-0407.12155","article-title":"Is additional hyperbaric oxygen therapy cost-effective for treating ischemic diabetic ulcers? Study protocol for the Dutch DAMOCLES multicenter randomized clinical trial?","volume":"7","author":"Stoekenbroek","year":"2015","journal-title":"J Diabetes"},{"key":"2022031301253315200_B19","doi-asserted-by":"crossref","first-page":"2191","DOI":"10.1001\/jama.2013.281053","article-title":"World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects","volume":"310","author":"World Medical","year":"2013","journal-title":"JAMA"},{"key":"2022031301253315200_B20","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1053\/ejvs.2002.1911","article-title":"The role of hyperbaric oxygen therapy in ischaemic diabetic lower extremity ulcers: a double-blind randomised-controlled trial","volume":"25","author":"Abidia","year":"2003","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"2022031301253315200_B21","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.2337\/diacare.19.12.1338","article-title":"Adjunctive systemic hyperbaric oxygen therapy in treatment of severe prevalently ischemic diabetic foot ulcer. A randomized study","volume":"19","author":"Faglia","year":"1996","journal-title":"Diabetes Care"},{"key":"2022031301253315200_B22","doi-asserted-by":"crossref","first-page":"998","DOI":"10.2337\/dc09-1754","article-title":"Hyperbaric oxygen therapy facilitates healing of chronic foot ulcers in patients with diabetes","volume":"33","author":"L\u00f6ndahl","year":"2010","journal-title":"Diabetes Care"},{"key":"2022031301253315200_B23","doi-asserted-by":"crossref","first-page":"392","DOI":"10.2337\/dc15-2001","article-title":"Hyperbaric oxygen therapy does not reduce indications for amputation in patients with diabetes with nonhealing ulcers of the lower limb: a prospective, double-blind, randomized controlled clinical trial","volume":"39","author":"Fedorko","year":"2016","journal-title":"Diabetes Care"},{"key":"2022031301253315200_B24","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1053\/j.jfas.2008.08.002","article-title":"Effect of hyperbaric oxygen therapy on healing of diabetic foot ulcers","volume":"47","author":"Duzgun","year":"2008","journal-title":"J Foot Ankle Surg"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/care.diabetesjournals.org\/syndication\/doi\/10.2337\/dc17-0654","content-type":"unspecified","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/41\/1\/112\/554096\/dc170654.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/41\/1\/112\/554096\/dc170654.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,13]],"date-time":"2022-03-13T05:15:28Z","timestamp":1647148528000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/41\/1\/112\/36680\/Hyperbaric-Oxygen-Therapy-in-the-Treatment-of"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,26]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,10,26]]},"published-print":{"date-parts":[[2018,1,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc17-0654","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,26]]}}}