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I was pleased to read your informative article, "Stepping up Care for Diabetic Foot Ulcers" (October 2005). I'd like to add that hyperbaric oxygen therapy (HBO) can reduce the risk of amputation from nonhealing diabetic foot ulcers in selected patients who don't respond to standard wound therapy.
Normal wound healing proceeds through an orderly sequence of steps, several of which are critically dependent on adequate perfusion and oxygen availability. The hypoxic nature of all wounds has been demonstrated. Pathologically increased hypoxia correlates with impaired wound healing and increased rates of infection. In HBO, high concentrations of oxygen are delivered under pressure to increase oxygen levels in the blood and tissues and promote wound healing. The benefit of HBO as a treatment for nonhealing wounds is well established, and it should be considered if available and appropriate.
CAROL AIKEN, RN, BSN
Johnson City, Tenn.
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