Besides being the part of the body that sustains us and helps us walk, the legs also ensure the return of the venous blood from body periphery to the heart. Unfortunately, they are often target of many diseases that manifest themselves in the form of:

• Pain
• Deformations of the muscle and/or bone structure
• Superficial lesions
• Swelling and fatigue
• Vascular Diseases etc.

One of the most common causes of complications in the lower limbs is DIABETES. Diabetes Mellitus is a chronic disease characterised by high levels of blood sugar caused by a deficiency of insulin secretion and/or action.

There are two types of Diabetes:
TYPE I DIABETES also known as Juvenile-onset or Insulin dependent Diabetes.
TYPE II DIABETES also known as Adult-onset or NON-Insulin dependent Diabetes.

High levels of glucose in blood cause chronic complications over time: retinopathy, nephropathy, neuropathy, vascular disease, DIABETIC FOOT syndrome.

Diagnosed/undiagnosed/high blood glucose/millions of people - Numbers of Diabetes in Italy and all over the world 47% of all non-traumatic major amputations of the lower limbs and 38% of minor amputations are performed on patients suffering from diabetes (with respect to 29% of the population). 85% of the diabetic amputations are preceded by ulcers and their presence is associated with a 50% increase in short term mortality risk.

Leg ulcers mainly affect the elderly (3-4% of the population over 65 years), representing a major chronic lesion all over the world (reported on 15% of the patients suffering from diabetes), and is a significant risk factor for hospitalization, amputation, sepsis and mortality. (* L. Monge, The integrated assistance in diabetic foot: The clinical pathway, G It Diabetol Metab 2009;29:197-206)

The main types of ulcers are: venous ulcers, arterial ulcers, diabetic ulcers and pressure ulcers.

Therapies for the treatment of skin lesions are aimed to:

• fight hypoxia by restoring Oxygen diffusion and reactivating the blood supply;
• activate tissue healing processes;
• fight infections;
• reduce the pain.

There are a series of ulcer-related problems that affect not only the patient, but the entire society. This complication implies problems for the patient, its family, the hospital structures and social problems (in terms of direct and indirect costs) that generate an increase of the social and care costs.

Hypoxia inhibits the healing process, reducing the collagen secretion of fibroblast, hindering the cellularity of the granulation tissue and favouring infections. Transcutaneous oximetry showed a pO2 of 5-10 mm of Hg at the level of vascular hepatic lesions.
Normobaric compartmental Oxygen therapy prevents hypoxia and speeds up wound healing process, stimulating revascularization (angiogenesis) thanks to the interactions between growth factors and cytokines, also promoting leukocytes activity and speeding up tissue regeneration.

---

EXAMPLES OF CLINICAL CASES TREATED WITH HO2ME:

---