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Homework answers / question archive / PICOT QUESTION: In patients with chronic diabetic foot ulcers, does treatment with adjunctive hyperbaric oxygen therapy compared to standard wound care alone improve the rate of wound healing and/or decrease the risk of amputation? Step 1: Formulate the Burning Clinical PICOT Question (5 points) This means develop an intro/background on why this is an important question and then state your question
PICOT QUESTION: In patients with chronic diabetic foot ulcers, does treatment with adjunctive hyperbaric oxygen therapy compared to standard wound care alone improve the rate of wound healing and/or decrease the risk of amputation?
Step 1: Formulate the Burning Clinical PICOT Question (5 points) This means develop an intro/background on why this is an important question and then state your question.
Use each of the keywords from the PICOT question to perform a systematic search (this skill was learned in Week 4). Discuss how you performed your search, including search terms and process.
Step 3: Critical Appraisal of Evidence (Initial Thoughts) (25 points)
Create an annotated bibliography on one qualitative and one quantitative studies that resulted from this search. Include the following for each article:
Applying the Steps of the Process for EBP
Step 1: PICOT Question
The PICOT question is: “In patients with chronic diabetic foot ulcers, does treatment with adjunctive hyperbaric oxygen therapy compared to standard wound care alone improve the rate of wound healing and/or decrease the risk of amputation?”
Step 2: Search Keywords
Keywords used are:
Step 3: Annotated Bibliography
Aguiar, P., Amaral, C., Rodrigues, A., & De Souza, A. H. (2017). A diabetic foot ulcer treated with hydrogel and hyperbaric oxygen therapy: a case study. Journal of wound care, 26(11), 692-695.
This study aims to evaluate hydrogel and hyperbaric oxygen therapy for the treatment of diabetic foot ulcers. Notably, the research question of this research can be described as follows: is the treatment for diabetic foot ulcers using hydrogel and hyperbaric oxygen effective in preventing bacterial infection compared to conventional methods? The research design is the case study design where researchers comprehensively followed up one case, and the results were documented. Usually, case studies are qualitative studies since the feelings and assumptions of the participant are described in the results, in addition to objective and subjective data collected during the study. The level of evidence is relatively low since this study is based on a low scale (one patient only). This research showed that hydrogel and hyperbaric oxygen therapy were effective in treating diabetic foot ulcers. Therefore, the authors concluded that those interventions should be recommended for cases with diabetic foot ulcers. This study is linkable to the PICOT question since it compared an intervention including hyperbaric oxygen to the conventional wound healing practices. Thus, the research question of this study has similarities with the PICOT question, and the results of this study can be used in answering the PICOT question.
Santema, K. T., Stoekenbroek, R. M., Koelemay, M. J., Reekers, J. A., Van Dortmont, L. M., Oomen, A., ... & Ubbink, D. T. (2018). Hyperbaric oxygen therapy in the treatment of ischemic lower-extremity ulcers in patients with diabetes: results of the DAMO2CLES multicenter randomized clinical trial. Diabetes care, 41(1), 112-119.
This quantitative research investigates the effectiveness of hyperbaric oxygen therapy for diabetic foot compared to conventional methods was studied; the purpose of this study is to explore whether the addition of hyperbaric oxygen therapy for diabetic patients having leg ulcers. The research hypothesis is that hyperbaric oxygen treatment can improve complete wound healing or limb salvage in patients with diabetes and lower-limb ischemia. This study follows the randomized clinical trial research design, and it was a multicenter, randomized, parallel-group superiority trial. The level of evidence is moderate to high since the study was conducted on 120 patients, and it considered many related issues as adverse effects and effectiveness of the studied intervention. Notably, the authors concluded that the addition of hyperbaric oxygen therapy for patients with a diabetic foot or lower limb ulcer does not significantly improve wound healing for the studied sample. The study findings can answer the PICOT question since this study compared the addition of the intervention identified in the picot question to using traditional/conventional methods in wound healing.
Applying the Steps of the Process for EBP
Step 1: PICOT Question
Diabetic patients are at high risk of developing ulcers in the lower limbs due to ischemia (Santema et al., 2018). And patients who have foot ulcers as a complication of diabetes are at risk of developing infections in their lower limbs (as bacterial infections), leading to amputation of some parts of the lower limbs (Aguiar et al., 2017). The conventional method of taking care of ulcers in lower limbs ulcers is standard wound care, where the wound is kept clean using normal saline and other standard care medications (Santema et al., 2018). Recently, using adjunctive hyperbaric oxygen therapy to treat foot ulcers to improve the rate of wound healing or to decrease the potential of amputation is being popular (Aguiar et al., 2017). The developed PICOT question is essential for the quality of life of people with foot ulcers since if the adjunctive hyperbaric treatment was evidenced to be effective and beneficial, patients with foot ulcers might benefit substantially from this evidence-based practice. Notably, project members will use extensive research of qualitative and quantitative published research to answer the PICOT question. The PICOT question is: “In patients with chronic diabetic foot ulcers, does treatment with adjunctive hyperbaric oxygen therapy compared to standard wound care alone improve the rate of wound healing and/or decrease the risk of amputation?”
Step 2: Search Keywords
Keywords used are:
Step 3: Annotated Bibliography
Aguiar, P., Amaral, C., Rodrigues, A., & De Souza, A. H. (2017). A diabetic foot ulcer treated with hydrogel and hyperbaric oxygen therapy: a case study. Journal of wound care, 26(11), 692-695.
This study aims to evaluate hydrogel and hyperbaric oxygen therapy for the treatment of diabetic foot ulcers. Notably, the research question of this research can be described as follows: is the treatment for diabetic foot ulcers using hydrogel and hyperbaric oxygen effective in preventing bacterial infection compared to conventional methods? The research design is the case study design where researchers comprehensively followed up one case, and the results were documented. Usually, case studies are qualitative studies since the feelings and assumptions of the participant are described in the results, in addition to objective and subjective data collected during the study. The level of evidence is relatively low since this study is based on a low scale (one patient only). This research showed that hydrogel and hyperbaric oxygen therapy were effective in treating diabetic foot ulcers. Therefore, the authors concluded that those interventions should be recommended for cases with diabetic foot ulcers. This study is linkable to the PICOT question since it compared an intervention including hyperbaric oxygen to the conventional wound healing practices. Thus, the research question of this study has similarities with the PICOT question, and the results of this study can be used in answering the PICOT question.
Santema, K. T., Stoekenbroek, R. M., Koelemay, M. J., Reekers, J. A., Van Dortmont, L. M., Oomen, A., ... & Ubbink, D. T. (2018). Hyperbaric oxygen therapy in the treatment of ischemic lower-extremity ulcers in patients with diabetes: results of the DAMO2CLES multicenter randomized clinical trial. Diabetes care, 41(1), 112-119.
This quantitative research investigates the effectiveness of hyperbaric oxygen therapy for diabetic foot ulcers compared to conventional methods. The purpose of this study is to explore whether the addition of hyperbaric oxygen therapy for diabetic patients having leg ulcers. The research hypothesis is that hyperbaric oxygen treatment can improve complete wound healing or limb salvage in patients with diabetes and lower-limb ischemia. This study follows the randomized clinical trial research design, and it was a multicenter, randomized, parallel-group superiority trial. The level of evidence is moderate to high since the study was conducted on 120 patients, and it considered many related issues as adverse effects and effectiveness of the studied intervention. Notably, the authors concluded that the addition of hyperbaric oxygen therapy for patients with a diabetic foot or lower limb ulcer does not significantly improve wound healing for the studied sample. Nevertheless, the study findings can answer the PICOT question since this study compared the addition of the intervention identified in the picot question to using traditional/conventional methods in wound healing.
