People with diabetes often develop foot problems because their skin becomes dry and cracked, which opens pathways for infection to enter the body. The hands and feet are most susceptible to infection because circulation is weakest at the extremities. Adding to these threats, nerve damage, known as diabetic neuropathy, can lead to a loss of feeling in the feet and the inability to notice a foot infection.
These diabetic foot ulcers require advanced wound care that sometimes includes hyperbaric oxygen therapy (HBOT). If a wound becomes chronic — that is, if it has not started to heal in two weeks or has not healed completely in four to six weeks — hyperbaric oxygen therapy can bring relief to the patient.
Without appropriate care, chronic wounds on the feet can lead to amputation. According to Nevada State Health Division statistics, more than 215, 000 Nevada adults have diabetes-related conditions that lead to chronic wounds. In 2009, more than 40 percent of lower extremity amputations in Nevada were performed on people with a primary diagnosis of diabetes.
Besides losing part of a limb, studies show that people with diabetes who have an amputation then have a 35 percent greater demand on the heart and lungs when they are mobile. Most do not live beyond five years after the amputation because of complications from diabetes.
Hyperbaric oxygen therapy is one of the most important elements of advanced wound care and has medical applications for a large variety of conditions. It increases the efficiency of the body’s oxygen-dependent, wound-healing mechanism by saturating the blood plasma with oxygen. This allows the plasma to carry 15 to 20 times the normal amount of healing oxygen to the body’s tissues. Oxygen-rich blood stimulates your body to release substances called growth factors and stem cells, which promote healing.
During treatment the patient reclines on a bed enclosed in a clear Plexiglass chamber. He or she breathes pure oxygen at an air pressure of 1.5 to three times normal atmospheric pressure. An HBOT technician supervises the therapy. Treatments are administered for two hours at a time, and patients can nap or watch a movie during the treatment.
Patients receive five treatments per week for several weeks, with a total of 30 to 50 treatments. As the wound heals, the number of required treatments may decrease.
To be most effective, hyperbaric oxygen therapy should be administered under the supervision of a physician. In clinical studies, hyperbaric oxygen therapy administered under the supervision of a physician has shown an almost 90 percent success rate in healing chronic wounds that previously would not heal. Northern Nevada Medical Center’s Wound Care Center provides this care, and patients should ask about physician supervision before seeking treatment at any wound care center.
To learn more about wound care and hyperbaric oxygen therapy, call the Wound Care Center at Northern Nevada Medical Center at 352-5353. The Wound Care Center is located at the Vista Medical Terrace at 2345 E. Prater Way.
Todd Inman, MD, is a family medicine physician at the Northern Nevada Medical Group and medical director for the Wound Care Center at Northern Nevada Medical Center. Dr. Inman earned his medical degree and completed his residency from the University of Nevada School of Medicine in Reno.