10 RCTs involving 715 participants. Eight RCTs evaluated autolytic debridement and included the following agents or dressings: biocellulose wound dressing (BWD), non‐adherent dressing, honey gel, hydrogel (gel formula), hydrofibre dressing, hydrocolloid dressings, dextranomer beads, Edinburgh University Solution of Lime (EUSOL) and paraffin gauze. Two RCTs evaluated enzymatic preparations and one evaluated biosurgical debridement.

. Winston had dropped his habit of drinking gin at all hours. He seemed to have lost the need for it. He had grown fatter, his varicose ulcer had subsided, leaving only a brown stain on the skin above his ankle, his fits of coughing in the early morning had stopped. The process of life had ceased to be intolerable, he had no longer any impulse to make faces at the telescreen or shout curses at the top of his voice. Now that they had a secure hiding-place, almost a home, it did not even seem a hardship that they could only meet infrequently and for a couple of hours at a time. What mattered was that the room over the junk-shop should exist. To know that it was there, inviolate, was almost the same as being in it. The room was a world, a pocket of the past where extinct animals could walk.

Although there are numerous indications and potential indications for HBOT, there are 14 accepted indications by Undersea and Hyperbaric Medical Society, and the FDA. Indications related to wounds and ulcers include clostridial myonecrosis, crush injury, radiation-induced soft tissue and bone necrosis, necrotizing soft tissue infections, diabetic ulcers Wagner III or higher, refractory osteomyelitis, and thermal burns.

UREA BREATH TESTSUrea breath tests require the ingestion of urea labeled with the nonradioactive isotope carbon 13 or carbon 14. Specificity and sensitivity approach 100%. Urea breath testing is one option for test of cure and should be performed four to six weeks after completion of eradication therapy. Proton pump inhibitors (PPIs) must be stopped for at least two weeks before the test, and accuracy is lower in patients who have had distal gastrectomy. Cost and inconvenience are disadvantages of this test.8STOOL MONOCLONAL ANTIGEN TESTSStool antigen tests using monoclonal antibodies are as accurate as urea breath tests if a validated laboratory-based monoclonal test is used.1,11 They are cheaper and require less equipment than urea breath tests. Like urea breath tests, stool antigen tests detect only active infection and can be used as a test of cure. PPIs should be stopped for two weeks before testing, but stool antigen tests are not as affected by PPI use as are urea breath tests.SEROLOGIC TESTSSerologic antibody testing detects immunoglobulin G specific to H. pylori in serum and cannot distinguish between an active infection and a past infection. Serologic tests may be most useful in mass population surveys and in patients who cannot stop taking PPIs (e.g., those with gastrointestinal bleeding or continuous NSAID use) because the tests are not affected by PPI or antibiotic use.1,2ENDOSCOPY WITH BIOPSYEndoscopy with biopsy is recommended to rule out cancer and other serious causes in patients 55 years or older, or with one or more alarm symptoms. In patients who have not been taking a PPI within one to two weeks of endoscopy, or bismuth or an antibiotic within four weeks, the rapid urease test performed on the biopsy specimen provides an accurate, inexpensive means of diagnosing H. pylori infection.2 Patients who have been on these medications will require histology, with or without rapid urease testing. Culture and polymerase chain reaction allow for susceptibility testing but are not readily available for clinical use in the United States.