The authors stated that 80 studies were included in the review. However, the results of only 65 studies were reported, as where there was systematic review evidence available for an indication, this was reported in preference to the results of primary studies included in the review. Sixty-five studies with more than 5,856 participants were reported: 2 systematic reviews, 38 randomised controlled trials (RCTs), 21 comparative studies, 3 comparative studies with historical controls, and 1 case series.
This section summarised the main findings of the review; for more specific details the reader is referred to the relevant sections of the report.
Thermal burns (8 studies): the studies were clinically and methodologically heterogeneous. Overall, there was little evidence to support the use of HBOT for this indication.
Diabetic wounds (5 studies): the studies were clinically and statistically homogeneous. The results showed that major amputations were less likely in diabetic patients with chronic ulceronecrotic lesions who were treated with HBOT than in patients receiving comparison therapies. It was also found that HBOT promoted wound healing and reduced the length of hospital stay, although it also increased the risk of minor amputations.
Non-diabetic wounds (1 study): based on the results of one small study, there was some evidence that treatment with HBOT was associated with decreases in the area of chronic, non-diabetic wounds.
Necrotising soft tissue infections (2 studies): the studies were clinically and methodologically heterogeneous. The results from one of the studies indicated that HBOT was associated with significant increases in overall survival. The results from the other study failed to reach significance for this outcome, and indicated that HBOT was associated with more operations and debridements.
Necrotising fasciitis (3 studies): the studies were small, clinically heterogeneous, and provided little information about the HBOT. There was little evidence from any of the included studies to support the use of HBOT for this indication.
Fournier's gangrene (1 study): survival was significantly better in patients who received HBOT than in those who received the comparison therapy alone. The results were based on a small retrospective cohort study.
Osteomyelitis (1 study): there were no significant differences between the group treated with HBOT and the comparison group in terms of length of hospitalisation, clinical outcome or risk of recurrence.
Osteoradionecrosis (2 studies): one study assessed prevention and the other assessed the treatment of osteoradionecrosis. The results of the study examining prevention showed that HBOT was more effective than penicillin in the prevention of osteoradionecrosis. The study that assessed treatment showed that patients who were treated with HBOT had significantly less failed implants and a higher survival rate in comparison with controls.
Skin graft survival (2 studies): both studies were poorly reported in terms of the patient population and comparison interventions. Therefore, no conclusions could be drawn regarding the effectiveness of HBOT for either myocutaneous flaps or split skin grafts.
Acute myocardial infarction (2 studies): neither of the studies provided evidence to support the use of HBOT for acute myocardial infarction. The studies either failed to find any benefit on major end points or suffered from flaws in the study design.
Cerebrovascular disease (2 studies): the results of the studies were conflicting and assessed only a small number of end points. Therefore, no evidence was found to support the use of HBOT in cerebrovascular disease.
Peripheral obstructive arterial disease (1 study): only one small trial was identified. The study did not provide any evidence of benefit with HBOT in patients with peripheral obstructive arterial disease.
Soft tissue injuries (acute ankle sprains and crush injuries) (2 studies): one study assessed patients with acute ankle sprains and one patients with crush injuries. The results of the former (ankle sprains) indicated no treatment benefit with adjunctive HBOT. The second small trial of patients with crush injuries of the lower limbs showed that HBOT benefited patients in terms of decreased surgical intervention, but not in terms of decreased healing time.
Cluster headaches (2 studies): two small, poor-quality studies showed some benefit of HBOT compared with the comparison therapy in relation to pain relief and physiochemical outcomes.
Migraine headaches (2 studies): both studies were small. Therefore, further research is needed to provide conclusive evidence of any treatment benefit with HBOT for this indication.
Facial paralysis (1 study): only one small study was included. The results provided some evidence of a benefit of HBOT in patients with moderate to severe facial paralysis of less than 1 week in duration.
Sudden deafness and acoustic trauma (4 studies): the studies provided conflicting evidence of any treatment benefit with HBOT within this indication.
Head and neck cancer (9 studies): the studies were clinically and methodologically heterogeneous. The results provided no support for there being any treatment benefit of HBOT in patients with head and neck cancer.
Cervical cancer (6 studies): no conclusions could be drawn regarding the effectiveness of HBOT in conjunction with radiotherapy for cervical cancer.
Bladder cancer (4 studies): the studies provided conflicting results on any survival benefit with HBOT in conjunction with radiotherapy for bladder cancer.
Lymphomas (1 study): the results indicated some benefits of HBO exposure in the treatment of lymphomas. However, the study was small and of poor methodological quality.
Lung cancer (1 study): this study provided no evidence of a treatment benefit of HBOT in patients with lung cancer.
Neuroblastoma (1 study): one small, poor-quality study showed some evidence of an effect of HBOT in patients with neuroblastoma.
Adverse events: those recorded that were associated with HBOT were myopia, barotraumas, oxygen toxicity, claustrophobia and decompression illness.