David J. Margolis, MD, PhD, from the University of Pennsylvania, in Philadelphia, and colleagues compared the effectiveness of HBO with other conventional therapies in a longitudinal observational cohort study including 6,259 individuals with diabetes, adequate lower limb arterial perfusion, and foot ulcers extending through the dermis.
In propensity score-adjusted models, the researchers found that individuals receiving HBO were significantly less likely to have healing of their foot ulcer (hazard ratio, 0.68) and significantly more likely to have an amputation (hazard ratio, 2.37). HBO was not found to improve the likelihood of wound healing or to reduce the likelihood of amputation in additional analyses including use of an instrumental variable to ascertain the robustness of the results to unmeasured confounding.
"In conclusion, HBO did not appear to be useful for the prevention of amputation and did not improve the likelihood that a wound would heal in a cohort of patients defined by Centers for Medicare and Medicaid Services eligibility criteria," write the authors.
Two authors disclosed financial ties to the National Healing Corp. One of the authors is a consultant to Healogics, which fully owns the National Healing Corporation.