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Comparing ESWT and HBOT Efficacy in Diabetic Foot Ulcers

Comparing ESWT and HBOT Efficacy in Diabetic Foot Ulcers

Title of Study: Molecular changes in diabetic foot ulcers

Authors: Ching-Jen Wang a, Jih-Yang Ko a, Yur-Ren Kuo b, Ya-Ju Yang a


The study evaluated the cellular effects of extracorporeal shockwave therapy (ESWT) versus hyperbaric oxygen therapy (HBOT) in treating chronic diabetic foot ulcers.


This research included 77 patients, divided into two groups: one group of 39 patients with 44 ulcers received ESWT and another of 38 patients with 40 ulcers underwent HBOT. Both groups were similar in demographic characteristics. ESWT patients had shockwave therapy twice a week, totaling six sessions, whereas HBOT patients underwent daily treatments for a total of 20 sessions. Ulcer biopsies were taken before and after treatment to analyze the levels of various healing-related proteins through immunostaining.


Post-treatment, the ESWT group showed significant improvements in the markers for blood vessel formation and tissue repair (vWF, VEGF, eNOS, PCNA, EGF), and a reduction in cell death (TUNEL). The changes in the HBOT group did not reach statistical significance. Initially, there were no significant differences between the groups in terms of these proteins, but after the treatments, the differences were significant, favoring ESWT.


The study concludes that ESWT is more effective than HBOT in promoting angiogenesis and tissue regeneration in the treatment of diabetic foot ulcers. ESWT led to marked increases in proteins associated with healing, suggesting it might be a superior treatment option in these cases.

This study suggests that for patients with chronic diabetic foot ulcers, ESWT could offer significant benefits in healing by enhancing key biological pathways involved in tissue recovery and blood vessel formation.

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