By: Shelagh McNally for Wounds1Many doctors are preventing diabetic amputations by using one of the most versatile and powerful compounds that we come across every second of every day: oxygen.
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An ounce of prevention is worth a pound of cure. The American Podiatric Medical Association recommends the following for diabetic foot care:
A daily foot wash with careful drying
A daily foot inspection for cuts, bruises, sores or changes to the toenail
Wear thick, soft socks with no seams
Cut toenails straight across
Buy properly fitting shoes
Don’t go barefoot
Exercise to get the blood pumping
Stop smoking and drinking. Both contribute to circulation problems
Lose weight to reduce pressure on your feet |
Each year in the United States, more than 80,000 people lose toes, a foot or even a leg due to complications of diabetes. Diabetics cope with a number of problems including hardening of the arteries and clogged capillaries that result in nerve damage. This diabetic neuropathy causes swollen feet and leads to a loss of feeling, making it difficult to find shoes that fit properly. When we stub a toe or have a blister, we feel it. Diabetics do not. Usually they don’t know they have had a foot injury until the skin breaks down and becomes infected. By then it can be too late and in many cases, amputation is the only solution. “Diabetics are the highest population for non-traumatic amputations,” explained Dr. A. J. Applewhite, a wound care specialist at The Wound Care Center at Methodist Charlton Medical Center
Applewhite is one of the many doctors successfully preventing diabetic amputation using hyperbaric oxygen therapy (HBO2). Patients are placed in a submarine-like chamber filled with 100 percent oxygen. This high intake of oxygen into their blood helps generate the growth of blood vessels. According to Jeffrey Stone, director of the hyperbaric medicine unit at the Institute for Exercise and Environmental Medicine (IEEM), “vessel growth is crucial for diabetics because they have circulatory problems due to blocked arteries and capillaries.”
In 2001, Stone and his colleagues at IEEM began studying HBO2 and found that it could reduce diabetic amputations. HBO2 is not a new treatment – it has been used to recompress deep-sea divers and prevent “the bends” since the 1930s. In 1965, a group of researchers noted that the victims of a mine explosions treated with HBO2 for their CO poisoning healed faster. It was quickly added as a treatment for wounds. The 2001 IEEM study focused specifically on diabetic treatment. Over a period of 33 months, 1,633 patients were followed. Out of 501 diabetic patients, 119 received hyperbaric oxygen therapy and the rest received conventional treatment. Stone found that the limb salvage rate was 72 percent for those on pure oxygen and only 53 percent for the rest. Shortly afterwards, HBO2 became part of diabetic wound care.
The Dallas Methodist Charlton Medical Center has taken the treatment a step further with its advanced wound care program. They offer classes to educate diabetics about the importance of caring for their feet and checking regularly for signs of injury or infection. Patients with non-healing wounds are immediately given HBO2 treatment. “Essentially what it does, is supersaturates the blood with oxygen,” said Dr. Applewhite. During the treatment patients can listen to music, watch television or take a nap. Depending on the severity of the wound or infection, patients can require four- to five-hour hyperbaric sessions. Other high-tech solutions include “Smart Dressing.” This dressing senses the condition of a wound, adding moisture if the wound is too dry or absorbing moisture if it is too wet.
Currently the Wound Care Center program has a 90 percent success rate, the highest in the country.
