Date of Award


Document Type

Restricted Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)


Physician Assistant Studies

First Advisor

Ryane Lester, PA-C


Background: People with diabetes are predisposed to developing foot ulcers that result in morbidity and mortality. Standard wound care is the gold standard for treatment of DFUs however, Hyperbaric Oxygen Therapy (HBOT) has been FDA-approved as an adjunctive therapy. HBOT has been theorized to increase oxygenation to the wound and therefore increase healing.

Method: PubMed was searched to identify randomized control trials (RCTs), systematic and meta-analysis comparing HBO plus standard wound care for DFUs to standard wound care alone. The main outcomes included healing of the ulcer and reduction in major amputations. Additionally, an interview with a hyperbaric Nurse Practitioner was performed to collect information on current clinical practice.

Results: The majority of studies suggested that adjunct therapy with HBO increases the healing process of DFUs. However, there is conflicting data as to if HBOT reduces amputation rates. While some studies stated that HBOT reduced major amputations in patients with DFUs, others determined there was no statistical significance.

Conclusion: It was analyzed that the conflicting evidence in the efficacy of HBOT and DFUs is primarily reliant on patient population. When the study specifically focused on Wagner Grade 3 and 4 ulcers, the studies reported increased healing with HBOT. The studies that did not classify the DFU or allowed a broad range of Wanger Grade ulcers, the reports often showed no significant benefit with HBOT. To establish a more concrete approach on the efficacy of HBOT for this condition, more studies should be performed specifically utilizing one of the classification systems.


SC 11.PAS.2020.Storo.K