Is combined physical therapy more effective than topical hyperbaric oxygen therapy in the treatment of venous leg ulcers? Preliminary study

Abstract

Abstract Introduction Recently, increased frequency of chronic leg ulcers has been observed. The aim of the study was to compare therapeutic efficacy of combined physical therapy to topical hyperbaric oxygen therapy in the treatment of venous leg ulcers. Materials and Methods Participants included 36 patients (14 females and 22 males) between 18 and 80 years of age with chronic venous leg ulcers. They were randomly divided into two study groups. Group I underwent topical hyperbaric oxygen therapy; group II underwent combined physical therapy. Before and after the therapeutic cycle (15 procedures) measurement of ulceration size by planimetry and analysis of laboratory parameters of blood was performed. Results In both groups, a statistically significant reduction of ulcer surface area was obtained (25.11±17.8cm2 to 16.93±13.89cm2, p=0.000196) vs. (34.17±14.82cm2 to 23.99±15.15cm2, p=0.004337). Blood morphology revealed a statistically significant reduction in patients from group II who underwent combined physical therapy (p=0.01). In both groups, statistically significant reduction of fibrinogen level (p=0.01 and p<0.001), and total protein level (p=0.01) was achieved. In group II reduction of the inflammation marker C-reactive protein (CRP) was noted. Conclusions Topical hyperbaric oxygen therapy and combined physical therapy had statistically significant effects on the reduction of surface area of treated venous leg ulcers. The changes in morphological and biochemical parameters may indicate the anti-inflammatory and anti-clotting action effects of combined physical therapy.