Rochelle Baker

ABOUT THIS REPORT

In 2012, CHRSP, in partnership with health system partners in Newfoundland and Labrador and the Canadian Agency for Drugs in Technology and Health (CADTH), published a contextualized health evidence synthesis report on the clinical effectiveness of hyperbaric oxygen therapy (HBOT) for difficult wound healing. For the 2012 study, the Project Team was led by CHRSP Research Officer Pablo Navarro, and by Rhonda Boudreau, Research Officer at CADTH. To provide decision makers with more recent evidence on this topic, the current report updates our original synthesis with evidence from systematic reviews published since 2010. Furthermore, this study was undertaken with an updated version of the CHRSP methodology, including a new CHRSP Evidence Rating System (ERS). The authors for this 2019 Evidence Update were CHRSP Research Officers Wendy Lasisi and Pablo Navarro.

SUMMARY OF KEY FINDINGS

The findings of this update are consistent with those of the original report and indicate that, overall, more high-quality research is needed in this area. The following summarizes the key findings from the new study.

1. As a treatment for diabetic foot ulcers, a strong body of evidence indicates that HBOT does not reduce minor amputations whereas weak evidence points to its effectiveness in reducing major amputations. These findings may be attributed to the fact that those undergoing a minor amputation will no longer require a major amputation (as a result, minor amputations do not decrease but major amputations do). A strong body of evidence shows that HBOT, as adjunctive therapy, is significantly more effective than usual care to reduce the severity of non-healing diabetic foot ulcers
2. HBOT has been shown to be clinically-effective in the treatment of delayed radiation-induced injuries of the head and neck and of the pelvic regions by improving wound healing and quality of life. The economic effectiveness of HBOT for treating these wounds is unknown.
3. The benefits of HBOT for wound healing will depend on the severity of the injury and on the timeliness of treatment.
4. There is insufficient evidence to determine the clinical or economic effectiveness of HBOT for the treatment of non-diabetic pressure ulcers, thermal burns, skin grafts and flaps, and post-organ transplantation revascularization.
5. More research is needed to determine the effectiveness of HBOT for healing a variety of wounds and decision makers can expect future studies to have an impact on the body of evidence for the effectiveness of HBOT to treat conditions for which there is insufficient evidence at present.
6. Monitoring and documenting patient outcomes at the St. John’s Hyperbaric Oxygen facility in Eastern Health will support future decisions about the most suitable patient populations for Hyperbaric Oxygen Therapy. The authors welcome input and discussion about the findings form this new study.

Please contact pnavarro@mun.ca if you would like to learn more or to arrange a meeting with the report authors