Recommendation ID
Further research should be undertaken to determine the clinical and cost effectiveness of the following therapies; negative pressure wound therapy, total contact casting, hyperbaric oxygen therapy and surgical debridement for diabetic foot problems.
Any explanatory notes
(if applicable)
The majority of major limb amputations occur in people with diabetes. In 85% of cases this is preceded by a non-healing ulcer or foot wound on the feet of people with diabetes are recognised as problematic to heal. Delayed healing results in inconvenience an increased morbidity, risk of amputation for patients, increased use of wound healing products and increased length of hospital stay. There is a need to improve the rate and success of wound healing in this patient group. Topical negative pressure therapy (TNP), Total Contact Casting (TCC), Hyperbaric Oxygen Therapy (HBOT) and Surgical Debridement is widely used and held to be an advantage by many health care professionals. However there is no convincing evidence to support its use. It can be
expensive, requires trained personnel to administer the intervention and may require the patient to remain in hospital during treatment if it is not available in the community.

A randomised clinical trial enrolling only patients with diabetic foot problems receiving HBOT is required to assess the costs associated with this intervention.

Source guidance details

Comes from guidance
Diabetic foot problems: Inpatient management of diabetic foot problems
Date issued
March 2011

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No