Wang et al. 2011
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Wang CJ, Wu RW, Yang YJ. Treatment of diabetic foot ulcers: a comparative study of extracorporeal shockwave therapy and hyperbaric oxygen therapy. Diabetes Res Clin Pract. 2011 May;92(2):187-93.
Design: Randomised Control Trial Subjects: 77 patients (84 feet) with diabetic foot ulcers were included in final analysis. Methods: Participants were randomised into two groups: 1. ESWT group: Focused shockwave therapy 2x / week for total 6 treatments (n=39 patients, n=44 feet), 2. HBOT group: Hyperbaric oxygen therapy daily for total 20 treatments (n=38 patients, n=40 feet). Outcomes included: Ulcer healing, complete healing, blood flow perfusion rates and histopathological examination. Results: • The overall clinical results showed significant differences in:
Key message: Extracorporeal shockwave therapy (ESWT) showed significant improvement in blood flow perfusion rate and cell activity leading to better healing of the ulcers in comparison to hyperbaric oxygen therapy in chronic diabetic foot ulcers.
• completely healed ulcers in ESWT (57%) and HBOT (25%) (P = 0.003); • ≥ 50% improved ulcers in ESWT (32%) and HBOT (15%) (P = 0.071); • unchanged ulcers in ESWT (11%) and HBOT (60%) (P < 0.001) • None worsened for the ESWT and the HBOT group respectively.
19 • Histopathological examination revealed considerable increases in cell proliferation and decreases in cell apoptosis in the ESWT group as compared to the HBOT group. • Blood flow perfusion rates were comparable between the two groups before treatment (P = 0.245); however, significant differences were noted after treatment favoring the ESWT group (P = 0.002).
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