Hyperbaric oxygen therapy (HBO) is a safe, noninvasive, and proven modality for healing chronic wounds resistant to traditional therapies. While HBO can be used as a stand-alone therapy, it is more often used as part of a combined treatment plan that includes antibiotics and advanced wound care or surgery. The treatment has particular relevance for individuals with diabetes, having clinically demonstrated improved outcomes for wound healing and reduced amputation rates.
The specific benefits of oxygen hypersaturation in the blood plasma include physiologic mechanisms that:
- Promote neovascularization in hypoxic tissue
- Promote fibroblast proliferation and collagen production, which are necessary for the formation of a healthy collagen matrix and essential to wound healing in hypoxic tissue
- Increase the rate of killing some bacteria by phagocytes
- Support marginally perfused/oxygenated tissues and provide interim oxygenation in relative states of ischemia
- May increase limb salvage in certain situations, especially wounds associated with diabetes
Who is a Candidate?
To combat a chronic stagnant wound or to prevent limb loss, hyperbaric oxygen therapy is appropriate for individuals with the following Medicare-approved conditions:
- Diabetic lower extremity wounds, such as foot and leg ulcers
- Venous stasis ulcers, arterial ulcers, and pressure ulcers
- Refractory osteomyelitis
- Necrotizing soft tissue infections
- Radiation damage to soft tissues and bone
- Crush injury
- Compromised skin grafts and flaps
- Acute vascular insufficiency
- Other non-healing wounds
Who is Not Eligible?
The Camden Clark Regional Wound and Hyperbaric Center multi-specialty team will work with referring physicians to evaluate each patient’s eligibility and specific benefits from advance wound healing or hyperbaric oxygen therapy. Hyperbaric oxygen therapy is not recommended in patients with untreated pneumothorax or who are pregnant.
What Patients Can Expect During HBO Therapy
The hyperbaric oxygen chamber is a large, clear acrylic cylinder where a patient lies comfortably on a reclining mattress. Over a 10-minute period, the atmosphere within the chamber is gradually increased to 2.0 ATM (1 atmosphere = 14.7 pounds per square inch) with 100 percent oxygen. During an average 90-minute session, the patient experiences a 20-fold increase in blood oxygen levels. This oxygen saturation is achieved through the chamber’s compression of the oxygen molecules, which allows increased oxygen diffusion in tissue fluids where it can exert its beneficial effects.
A single treatment normally lasts between one and two hours. Depending on the individual treatment plan, delivery may occur five days a week for up to six weeks. Many times, perceptible treatment benefits can be observed following one to two treatments.
Throughout the treatment session, patients are able to watch television, listen to music, talk with staff, or sleep. Since the increased oxygen does not affect the external wound site, wound dressings are usually left in place during the session.