Hillber Daniel Pasaribu, Taureni Hayati, Ardhestiro Harnindyo Putro

Hubungan Terapi Oksigen Hiperbarik terhadap Perbaikan Kaki Diabetik di Sebuah Rumah Sakit Militer di Jakarta

Introduction

Hubungan terapi oksigen hiperbarik terhadap perbaikan kaki diabetik di sebuah rumah sakit militer di jakarta. Evaluasi efektivitas Terapi Oksigen Hiperbarik (TOHB) untuk perbaikan kaki diabetik di RS Militer Jakarta. Penelitian menunjukkan peningkatan signifikan, terutama >10 sesi, mengurangi keparahan.

Abstract

Diabetes Mellitus (DM) is a chronic metabolic disease with a high global prevalence. A serious complication, diabetic foot, can cause high morbidity and an increased risk of amputation. In Indonesia, about 15% of DM patients develop diabetic foot, with an amputation rate reaching 30%. Hyperbaric Oxygen Therapy (HBOT) is offered as an adjunctive therapy to improve tissue oxygenation, angiogenesis, and wound healing. This study evaluates the effectiveness of HBOT in improving diabetic foot based on the Wagner score through a retrospective observational design using secondary medical records from 2021–2024. A total of 30 patients were analyzed using the Friedman and Wilcoxon tests. The results showed a significant association between HBOT and diabetic foot improvement (p < 0.001), particularly in patients undergoing more than 10 therapy sessions, who exhibited significant Wagner score improvement (p < 0.001). These findings confirm HBOT’s role in reducing diabetic foot severity. Keywords: Hyperbaric Oxygen Therapy, Adjunct Therapy, Diabetic Foot Abstrak Diabetes Mellitus (DM) adalah penyakit metabolik kronis dengan prevalensi tinggi global. Komplikasi serius, yaitu kaki diabetik, dapat menimbulkan morbiditas tinggi dan risiko amputasi; di Indonesia, sekitar 15% pasien DM mengalami kaki diabetik dengan angka amputasi mencapai 30%. Terapi Oksigen Hiperbarik (TOHB) ditawarkan sebagai terapi tambahan untuk meningkatkan oksigenasi jaringan, angiogenesis, dan penyembuhan luka. Penelitian ini mengevaluasi efektivitas TOHB terhadap perbaikan kaki diabetik berdasarkan skor Wagner melalui desain observasional retrospektif menggunakan data sekunder rekam medis pasien tahun 2021–2024. Sebanyak 30 pasien dianalisis dengan uji Friedman dan Wilcoxon. Hasil menunjukkan hubungan signifikan antara TOHB dan perbaikan kaki diabetik (p < 0,001), terutama pada pasien yang menjalani ?10 sesi terapi yang mengalami peningkatan skor Wagner signifikan (p < 0,001). Temuan ini mengonfirmasi bahwa TOHB berkontribusi signifikan menurunkan derajat keparahan kaki diabetik. Kata Kunci: Terapi Oksigen Hiperbarik, Terapi Tambahan, Kaki Diabetik

Review

This study addresses a critical clinical challenge, diabetic foot complications, which are a major cause of morbidity and amputation globally, particularly in Indonesia where rates are alarmingly high. The authors investigate the efficacy of Hyperbaric Oxygen Therapy (HBOT) as an adjunctive treatment, leveraging a retrospective observational design to analyze secondary medical records. The finding of a significant association between HBOT and improved Wagner scores, especially after more than 10 sessions, provides encouraging evidence for its potential role in reducing the severity of diabetic foot. This preliminary data is valuable, supporting the utility of HBOT in enhancing tissue oxygenation and wound healing, and contributing to the growing body of literature on managing this complex condition. While the study presents promising results, the retrospective observational design inherently limits the ability to establish a definitive causal relationship due to potential confounding variables and selection biases. The sample size of 30 patients, while a starting point, may limit the generalizability of the findings and the statistical power to detect more subtle effects or subgroup differences. Additionally, the abstract does not detail other crucial aspects of patient care, such as glycemic control, concurrent wound management protocols, or specific HBOT parameters (e.g., pressure, duration per session). These factors could significantly influence treatment outcomes and their absence in the summary makes it challenging to fully contextualize the observed improvements solely attributed to HBOT. Despite these methodological considerations, the study's positive findings warrant further investigation. This research serves as a valuable pilot, suggesting that HBOT is a promising adjunctive therapy for diabetic foot. Future research should aim to confirm these findings through more robust methodologies, such as prospective, randomized controlled trials with larger cohorts and multi-center participation, to control for confounding variables and enhance generalizability. Detailed reporting on HBOT protocols, alongside comprehensive data on patient comorbidities and concomitant treatments, would strengthen the evidence base. Ultimately, this paper contributes to the understanding of HBOT's potential in a challenging patient population and sets a foundation for more rigorous clinical studies to firmly establish its efficacy and cost-effectiveness.

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