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Evidence to Improve Care

Hyperbaric Oxygen Therapy for the Treatment of Diabetic Foot Ulcers

Ontario Health Technology Advisory Committee Recommendation

  • The Ontario Health Technology Advisory Committee concludes that the current evidence is insufficient to assess the benefits of hyperbaric oxygen therapy in healing diabetic foot ulcers. Given the low quality of the available evidence, the effectiveness of this treatment cannot be determined

Read the full OHTAC Recommendation report


About 15% to 25% of patients with diabetes will develop a foot ulcer, which is an open sore on the foot. When diabetic foot ulcers do not heal, the affected foot may need to be amputated; people with diabetes experience lower limb amputation at about 20 times the rate of people without diabetes. When the foot ulcer does not heal despite optimal wound care, other therapeutic interventions may be offered, one of which is hyperbaric oxygen therapy.

This review compares the safety, effectiveness, and cost-effectiveness of standard wound care plus hyperbaric oxygen therapy versus standard wound care alone for the treatment of diabetic foot ulcers. The review also examines the lived experience of patients who have undergone treatment with hyperbaric oxygen therapy.

Health Quality Ontario Reviews Hyperbaric Oxygen Therapy for the Treatment of Diabetic Foot Ulcers

In hyperbaric oxygen therapy, a patient enters a chamber that may fit a single person or multiple individuals. They are exposed to 100% oxygen while the atmospheric pressure is increased. To receive treatment, patients typically attend a hyperbaric oxygen therapy clinic five times a week and sit in a chamber for approximately 90 minutes at each visit.

Hyperbaric Oxygen Therapy for the Treatment of Diabetic Foot Ulcers: A Health Technology Assessment
May 2017

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No recommendation was made.

The Ministry of Health and Long-Term Care has provided the following response: The Ontario Health Insurance Plan currently funds hyperbaric oxygen therapy for the enhancement of healing in selected problem wounds, among other conditions.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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