Adolopment of guidelines for diabetic foot ulcers: an umbrella review with de novo meta-analysis of randomized controlled trials evaluating effectiveness and safety of hyperbaric oxygen therapy for chronic diabetic foot ulcers

KLUGAR, Miloslav, Lucia KANTOROVÁ, Andrea POKORNÁ, Tereza VRBOVÁ, Michal HÁJEK and Jitka KLUGAROVÁ. Adolopment of guidelines for diabetic foot ulcers: an umbrella review with de novo meta-analysis of randomized controlled trials evaluating effectiveness and safety of hyperbaric oxygen therapy for chronic diabetic foot ulcers. In GIN Conference 2021. 2021.

Basic information

• Original name: Adolopment of guidelines for diabetic foot ulcers: an umbrella review with de novo meta-analysis of randomized controlled trials evaluating effectiveness and safety of hyperbaric oxygen therapy for chronic diabetic foot ulcers
• Authors: KLUGAR, Miloslav (203 Czech Republic, belonging to the institution), Lucia KANTOROVÁ (703 Slovakia, belonging to the institution), Andrea POKORNÁ (203 Czech Republic, belonging to the institution), Tereza VRBOVÁ (203 Czech Republic, belonging to the institution), Michal HÁJEK (203 Czech Republic, belonging to the institution) and Jitka KLUGAROVÁ (203 Czech Republic, belonging to the institution).
• Edition: GIN Conference 2021, 2021.

Other information

• Original language: English
• Type of outcome: Presentations at conferences
• Field of Study: 30202 Endocrinology and metabolism
• Country of publisher: Czech Republic
• Confidentiality degree: is not subject to a state or trade secret
• RIV identification code: RIV/00216224:14110/21:00122798
• Organization unit: Faculty of Medicine
• Keywords in English: hyperbaric oxygen therapy; chronic diabetic foot ulcers; clinical practice guideline

Abstract

Background One of the approved guidelines by the Czech Health Research Council in the project Clinical Practice Guidelines is the guideline focused on the issue of Diabetic foot ulcers (DFU). There were identified several existing high-quality guidelines which were adapted, however the question of the effectiveness of hyperbaric oxygen therapy was not sufficiently developed in none of the identified guidelines. Objective The objective of this work is to evaluate the effectiveness and safety of hyperbaric oxygen therapy (HBOT) of chronic diabetic foot ulcers (CDFU) for the need of DFU guideline adolopment. Methods The existing evidence in identified guidelines regarding the effectiveness of HBOT of CDFU was not sufficiently developed, so we first searched an Epistemonikos and identified 25 eligible systematic reviews (SR) with mutually conflicting results. No of the umbrella review existed or were registered, so we registered the protocol of our umbrella review first. As the results of SR were conflicting, despite the fact we followed JBI methodology for umbrella reviews we developed de novo meta-analysis, with detailed sensitivity and subgroup analyses for risk of bias, number of HBOT sessions, peripheral arterial disease patients, and Wagner grade. We carried out a GRADE assessment of the certainty of evidence and recommendation development. Results Findings We found 25 eligible systematic reviews and extracted data from 18 RCTs with 1222 patients. Discussion HBOT likely increases healing rates, may decrease the number of amputations, and is not associated with severe adverse events or increased mortality in chronic diabetic foot ulcers.

Links

• LTC20031, research and development project: Name: Towards an International Network for Evidence-based Research in Clinical Health Research in the Czech Republic

Investor: Ministry of Education, Youth and Sports of the CR, INTER-COST

• 2019-1-CZ01-KA202-061350, interní kód MU: Name: Strategic Partnership in Innovation and Development of Evidence-Based Healthcare (Acronym: SPIDER)

Investor: European Union, Strategic Partnerships in the field of education, training and youth