The Role of VEGF and TNF-Alpha on Epithelialization of Diabetic Foot Ulcers after Hyperbaric Oxygen Therapy

Authors

  • I Nyoman Semadi Thorax and Cardiovascular Surgery Division, General Surgery Department, Faculty of Medicine Udayana University, Sanglah General Hospital, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2019.297

Keywords:

VEGF, TNF-α, epithelialization, diabetic foot ulcers, hyperbaric oxygen therapy

Abstract

BACKGROUND: Around 15-25% of diabetes mellitus (DM) patients will develop diabetic foot ulcers (DFUs) with high morbidity, many studies have been proposed to search the most effective healing techniques.

AIM: This study was conducted to demonstrate the ability of hyperbaric oxygen therapy (HBOT) as a complementary therapy in DFUs healing through raising vascular endothelial growth factor (VEGF) levels and suppressing tumour necrosis factor-alpha (TNF-α).

METHODS: All patients received the same treatment including wound debridement and wound care, but the patients in the HBOT group, breathed 100% oxygen at 2.4 ATA for 90 minutes in total of 20 sessions (four weeks).

RESULT: There were 32 diabetic patients with DFUs Wagner 3-4. VEGF levels after four weeks of HBOT was significantly elevated compared to the control group (p = 0.013). The effect size of VEGF levels was p = 0.005. TNF-α levels after four weeks of therapy were decreased (p = 0.01). Faster epithelialization is seen in the HBOT group (p < 0.001). We also performed path analysis, HBOT had a significant effect on the epithelialization (p < 0.001) and VEGF levels affected the epithelialization process (p = 0.042).

CONCLUSION: HBOT administration leads to increased VEGF levels, decreased TNF-α levels, and accelerated wound healing of DFUs patients. HBOT directly aids epithelialization and indirectly through VEGF upsurge and TNF-α downturn.

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Published

2019-08-20

How to Cite

1.
Semadi IN. The Role of VEGF and TNF-Alpha on Epithelialization of Diabetic Foot Ulcers after Hyperbaric Oxygen Therapy. Open Access Maced J Med Sci [Internet]. 2019 Aug. 20 [cited 2024 Mar. 28];7(19):3177-83. Available from: https://oamjms.eu/index.php/mjms/article/view/oamjms.2019.297

Issue

Section

B - Clinical Sciences

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