Can Topical Oxygen Have An Impact On DFU Healing?

Data continue to accumulate for some role of topical oxygen (TOT) in tissue repair and wound healing.  A study from Golledge and colleagues in Australia reveals some interesting developments.¹ Their systematic review and meta-analysis examined evidence for the benefit of topical oxygen therapy in healing diabetic foot ulcers (DFUs).¹

Investigators identified randomized, controlled trials on the topic with a primary outcome of ulcer healing. They performed meta-analyses using random effect models and reported risk ratios and 95 percent confidence intervals. They also examined study quality and publication bias using a modified Cochrane Collaboration tool and funnel plots.¹

Researchers included a total of six trials on topical oxygen, involving 530 participants with a DFU. Meta-analysis found that treatment with topical oxygen significantly increased the chance of ulcer healing compared to controls. Risk of bias varied among the studies (high, moderate and low in two, one and three studies, respectively).¹ The three trials at low risk for bias also suggested that TOT increased the likelihood of ulcer healing compared to controls. Funnel plots suggested a possibility of publication bias, however. Lastly, the available data on rates of amputation was not sufficient for meta-analysis.¹

Overall, this study is important as it suggests that topical oxygen therapy could improve rates of DFU healing, however we need more focused and definitive information on how it impacts amputation rates and health-care costs. In our practice, our initial experience with this technology has been promising, but we've not yet had the ability to use it in any widespread sense on our patients. Not too many years ago, I was skeptical as to how a treatment such as this could work. However, I now feel that point of view may have been in error. Most of the studies I’ve either participated in or have reviewed on the topic now have been positive, and we look forward to further data that will confirm or refute this.

Dr. Armstrong is Professor of Surgery at the Keck School of Medicine at the University of Southern California. He is the Director of the Southwestern Academic Limb Salvage Alliance (SALSA). 

Editor’s note: This blog originally appeared at: https://diabeticfootonline.com/2021/04/25/topical-oxygen-and-wound-healing-results-from-a-systematic-review-and-meta-analysis/ . It is adapted with permission from the author.

Disclaimer: The views and opinions expressed are those of the author(s) and do not necessarily reflect the official policy or position of Podiatry Today or HMP Global, their employees and affiliates. Any content provided by our bloggers or authors are of their opinion and are not intended to malign any religion, ethnic group, club, association, organization, company, individual, anyone or anything.

Reference

1. Thanigaiami S, Singh T, Golledge J. Topical oxygen therapy for diabetes-related foot ulcers: a systematic review and meta-analysis. Diabet Med. 2021. Online ahead of print. doi: 10.1111/dme.14585.