Frequent Treatment Improves Diabetic Ulcer Recovery Outcomes

For each type of DFU or VLU, one group had every-other-week visits--defined as more than 10 days between visits in the first 4 weeks--whereas the other group had weekly visits, defined as at least once a week. The main outcome measure was median time to wound closure.

The results showed that for patients with DFUs, 63.8% of wounds had closed in the weekly visit group after 4 weeks, compared with just 2% in the every-other-week group; for patients with VLUs, 78 of 105 wounds (52%) closed in the weekly visit group compared with none in the every-other-week group. After controlling for all covariates, the median time to close for weekly patients was 28 days versus 66 days for patients seen every other week. Adjusted median times to close VLUs in the same groups were 25 versus 55 days. The study was published in the November 2012 issue of Advances in Skin & Wound Care.

“More frequent visits can be extremely beneficial, with implications of lower costs and higher quality of life for patients,” concluded lead author Robert Warriner III, MD, former chief medical officer of Healogics [Dr. Warriner passed away a few months before the article was published].

The mainstay treatment for diabetic ulcers is hyperbaric oxygen therapy (HBOT). During treatment, hyperbaric oxygen is delivered in a chamber pressurized at 1.4 to 3.5 times the normal sea-level atmospheric pressure. The patients breathe 100% oxygen during therapy, sometimes with short “air breaks” of normal air to ensure patients will avoid oxygen toxicity. Patients with DFUs may undergo a total of 40 or more daily treatments, 5 to 6 days per week, for a number of weeks.

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