Synergistic Effect of Hyperbaric Oxygen and Decellularized Human Amniotic Membrane on Full-Thickness Diabetic Wound Healing in Rats

 Background and purpose: One of the common complications of diabetes is impairment of wound healing. The aim of the present study was to investigate the synergistic effect of hyperbaric oxygen (HBO) therapy and decellularized human amniotic membrane (dHAM) in healing of full-thickness diabetic wounds in rats. Materials and methods: In this experimental study, 60 diabetic male rats were randomly divided into four groups (n=15) as follows: untreated diabetic wound, wound treated with HBO, wound treated with dHAM, and wound treated with HBO+dHAM. Sampling was performed after 7, 14, and 21 days following wounding. Assessments included wound closure rate, histological (collagen density) and stereological examinations, expression of genes involved in repair and angiogenesis (TGF-β and VEGF), inflammatory genes (TNF-α and IL-1β), and wound tissue biomechanical properties. Results: Combined use of dHAM and HBO significantly increased wound closure rate, new epidermis and dermis volume, fibroblast cell and blood vessel density, collagen density, repair and angiogenesis genes, and wound biomechanical properties compared with those in the diabetic group (P<0.05). Also, the expression level of inflammatory genes and neutrophil density significantly decreased in all treatment groups, especially in HBO+dHAM group compared with the diabetic group (P<0.05). Conclusion: dHAM and HBO had a greater effect on the healing process of diabetic wounds when taken together than when each was taken separately.