Open AccessThe effect of continuous diffusion of oxygen treatment on cytokines, perfusion, bacterial load, and healing in patients with diabetic foot ulcers
Author(s) -
Lavery Lawrence A.,
Killeen Amanda L.,
Farrar David,
Akgul Yucel,
Crisologo Peter A.,
Malone Matthew,
Davis Kathryn E.
Publication year - 2020
Publication title -
international wound journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.867
H-Index - 63
eISSN - 1742-481X
pISSN - 1742-4801
DOI - 10.1111/iwj.13490
Subject(s) - medicine , perfusion , diabetic foot , diabetic foot ulcer , gastroenterology , diabetes mellitus , interleukin 8 , vascular endothelial growth factor , proinflammatory cytokine , urology , cytokine , surgery , vegf receptors , inflammation , endocrinology
Abstract To evaluate continuous diffusion of oxygen therapy (CDO) on cytokines, perfusion, and bacterial load in diabetic foot ulcers we evaluated 23 patients for 3 weeks. Tissues biopsies were obtained at each visit to evaluate cytokines and quantitative bacterial cultures. Perfusion was measured with hyperspectral imaging and transcutaneous oxygen. We used paired T tests to compare continuous variables and independent T tests to compare healers and nonhealers. There was an increase from baseline to week 1 in TGF‐β ( P = .008), TNF‐α ( P = .014), VEGF ( P = .008), PDGF ( P = .087), and IGF‐1 ( P = .058); baseline to week 2 in TGF‐β ( P = .010), VEGF ( P = .051), and IL‐6 ( P = .031); and baseline to week 3 with TGF‐β ( P = .055) and IL‐6 ( P = .054). There was a significant increase in transcutaneous oxygen after 1 week of treatment on both medial and lateral foot ( P = .086 and .025). Fifty‐three percent of the patients had at least a 50% wound area reduction (healers). At baseline, there were no differences in cytokines between healers and nonhealers. However, there was an increase in CXCL8 after 1 week of treatment ( P = .080) and IL‐6 after 3 weeks of treatment in nonhealers ( P = .099). There were no differences in quantitative cultures in healers and nonhealers.