BACKGROUND: Chronic wounds are common and present a health problem with significant effect on quality of life. Various pathologies may cause tissue breakdown, including poor blood supply resulting in inadequate oxygenation of the wound bed. Hyperbaric @entity26 therapy (HBOT) has been suggested to improve @entity26 supply to wounds and therefore improve their healing. OBJECTIVES: To assess the benefits and harms of adjunctive HBOT for treating chronic @entity1066 of the lower limb. SEARCH METHODS: For this second update we searched the Cochrane Wounds Group Specialised Register (searched 18 February 2015); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2015, Issue 1); Ovid MEDLINE  (1946 to 17 February 2015); Ovid MEDLINE (In-Process _ Other Non-Indexed Citations, 17 February 2015); Ovid EMBASE (1974 to 17 February 2015); and EBSCO CINAHL (1982 to 17 February 2015). SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing the effect on chronic wound healing of therapeutic regimens which include HBOT with those that exclude HBOT (with or without sham therapy). DATA COLLECTION AND ANALYSIS: Three review authors independently evaluated the risk of bias of the relevant trials using the Cochrane methodology and extracted the data from the included trials. We resolved any disagreement by discussion. MAIN RESULTS: We included twelve trials (577 @entity1 ). Ten trials (531 @entity1 ) enrolled @entity1 with a @entity4760 : pooled data of five trials with 205 @entity1 showed an increase in the rate of @entity1066 (risk ratio (RR) 2.35, 95% confidence interval (CI) 1.19 to 4.62; P = 0.01) with HBOT at six weeks but this benefit was not evident at longer-term follow-up at one year. There was no statistically significant difference in major amputation rate (pooled data of five trials with 312 @entity1 , RR 0.36, 95% CI 0.11 to 1.18). One trial (16 @entity1 ) considered @entity3179 and reported data at six weeks (wound size reduction) and 18 weeks (wound size reduction and number of @entity1066 healed) and suggested a significant benefit of HBOT in terms of reduction in @entity1066 area only at six weeks (mean difference (MD) 33.00%, 95% CI 18.97 to 47.03, P < 0.00001). We identified one trial (30 @entity1 ) which enrolled @entity1 with non-healing @entity6 as well as @entity3179 ("mixed @entity1066 types") and @entity1 were treated for 30 days. For this "mixed @entity1066 " there was a significant benefit of HBOT in terms of reduction in @entity1066 area at the end of treatment (30 days) (MD 61.88%, 95% CI 41.91 to 81.85, P < 0.00001). We did not identify any trials that considered arterial and pressure @entity1066 . AUTHORS' CONCLUSIONS: In @entity1 with foot @entity1066 due to @entity6 , HBOT significantly improved the @entity1066 healed in the short term but not the long term and the trials had various flaws in design and/or reporting that means we are not confident in the results. More trials are needed to properly evaluate HBOT in @entity1 with chronic wounds; these trials must be adequately powered and designed to minimise all kinds of bias.

Hyperbaric XXXX therapy for chronic wounds.

@entity1 :: ('9606', 'Species') :: ['participants', 'patients', 'people'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetic ulcers', 'diabetes'] @entity1066 :: ('MESH:D014456', 'Disease') :: ['ulcer', 'ulcer healing', 'ulcers'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity3179 :: ('MESH:D014647', 'Disease') :: ['venous ulcers'] @entity4760 :: ('MESH:D017719', 'Disease') :: ['diabetic foot ulcer']
@entity26 :: (MESH:D010100,Chemical) :: ['oxygen']
