Hyperbaric oxygen therapy (HBOT) is an effective adjunct to traditional wound care therapies, including topical cleaning;
surgical removal (debridement) of dead skin and tissue; application of dressings, ointments, and biologics; and use of
compression boots or stockings, vacuum or negative pressure wound therapy (NPWT) pumps, ultrasound, laser, and other emerging
technologies. HBOT helps repair wounds and enhance healing by improving blood circulation, encouraging the formation of new
capillary blood vessels (angiogenesis), supplying more oxygen to tissue in the wound bed, and stimulating the growth and
distribution of stem cells. Hyperbaric oxygen also helps kill the anaerobic bacteria that cause some of the worst infections
in chronic wounds. Evidence for HBOT is especially strong in diabetic foot ulcers classified Wagner Grade 3 or higher, for
which hyperbaric oxygen is widely considered standard therapy.
Read the page
Arterial Insufficiencies: Enhancement of Healing in Selected Problem Wounds
in the Undersea and Hyperbaric Medical Society resource library to learn more about wound evaluation, hypoxia, measures of
wound oxygenation, the mechanisms and efficacy of hyperbaric oxygen, and future areas for research.
In 2016, Diabetes Care, a journal of the American Diabetes Association, reported that a 2015 double-blind,
randomized, controlled clinical trial conducted in Canada found “HBOT does not offer an additional advantage
to comprehensive wound care in reducing the indication for amputation or facilitating wound healing in patients with chronic DFUs
[diabetic foot ulcers].”
[ Diabetes Care, 2016 ]
The results of this study are in contrast to other clinical trials that did not use a sham placebo as part of their methodology.
Hyperbaric oxygen plays an increasingly important role in the treatment of problem wounds and limb salvage. But access to
accredited hyperbaric facilities and certified hyperbaric physicians and technicians is a public health problem. In 2004
as many as two-thirds of nursing home patients with NPUAP Stage II or worse pressure ulcers were not enrolled in wound care
[ NCHS, 2011 ].
In diabetes-related wounds alone, US hospitals performed 66,000 toe, foot, and leg amputations
[ CDC, 2011 ],
for which health economists have estimated a cost of $3 billion per year
[ ACA, 2008 ].
More and more hospitals and health networks today are opening advanced wound care and hyperbaric centers to serve this unmet
clinical need. Even if chronic wounds were its only indicated use, HBOT would be assured a place in evidence-based medicine for quality and