Extracorporeal Shockwave Treatment for Chronic Diabetic Foot Ulcers
Title: Extracorporeal Shockwave Treatment for Chronic Diabetic Foot Ulcers
Authors: Ching-Jen Wang, M.D., Yur-Ren Kuo, M.D., Ph.D., Re-Wen Wu, M.D., Rue-Tsuan Liu, M.D., Chi-Shiung Hsu, M.D., Feng-Sheng Wang, Ph.D., Kuender D. Yang, M.D.
This study compared the effectiveness of two therapies for chronic diabetic foot ulcers: extracorporeal shockwave treatment (ESWT) and hyperbaric oxygen therapy (HBO). The study included 72 patients, randomly assigned to either ESWT or HBO. Patients in the ESWT group received shockwave therapy every two weeks for six weeks, while those in the HBO group received daily hyperbaric oxygen treatment for 20 sessions.
The study found that ESWT was significantly more effective than HBO for promoting the healing of diabetic foot ulcers. Of the patients receiving ESWT, 31% experienced complete healing, 58% experienced improvement, and only 11% saw no change. By comparison, in the HBO group, only 22% achieved complete healing, while 50% improved, and 28% saw no change.
The researchers also analyzed the underlying mechanisms of ESWT and found that it increased local blood flow perfusion, cell concentration, and activity more than HBO. They observed significant increases in the expression of molecules involved in endothelial cell growth and proliferation, which are essential for wound healing, and a decrease in expression of cell death markers.
The findings suggest that ESWT is a promising therapy for diabetic foot ulcers, which can be challenging to treat and often lead to serious complications.