Comparison of the therapeutic effects in patients with venous leg ulcers treated with routine therapy supplemented by topical hyperbaric oxygen therapy or routine therapy only, basing on the measurement of selected inflammatory markers and blood coagulation parameters: a retrospective study

Introduction
Venous leg ulcers (VLUs) are one of the most common civilization-related diseases which constitute a serious therapeutic and medical problem.

Aim
The aim of the study was to compare treatment results in patients with chronic venous leg ulcers using comprehensive therapy including topical hyperbaric oxygen therapy (HBOT).

Material and methods
The study included 57 patients: 25 (43.8%) males and 32 (56.1%) females, aged between 41 and 88 years. The patients were divided into two study groups. Group 1 (n = 29) received routine pharmacological treatment, specialized medical dressings, compression therapy and topical HBOT procedures. Group 2 (n = 28) received pharmacological treatment, medical dressings, and compression therapy. The ulcer surface area assessed using the planimetric method was compared, and selected inflammatory markers (serum concentration of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell count (WBC)), selected coagulation parameters (blood concentration of fibrinogen, serum concentration of D-dimer) were assessed.

Results
After treatment, the ulcer area in patients in group 1, in which local HBOT used, was statistically significantly smaller compared to group 2 (7.12 cm² (4.65–8.56) vs. 8.98 cm² (6.48–10.18); p = 0.019). Inflammatory markers showed statistically significantly (p = 0.036; effect size – 0.27) lower values of CRP concentration in group 1: 5.8 mg/l (2.27–12) compared to group 2: 8.53 mg/l (6.3–20.86).

Conclusions
Treatment results for patients with VLUs indicates a more effective anti-inflammatory effect of comprehensive therapy including topical HBOT, with no significant influence of this method on the parameters of blood coagulation.