We sat down with James Edlund, MD, medical director, PPG – Wound Care to explore how hyperbaric oxygen therapy (HBOT) contributes to increased recovery of non-healing wounds.
What is hyperbaric oxygen therapy and how does it work?
Hyperbaric oxygen therapy (HBOT) is a noninvasive supplemental wound healing treatment. During the procedure, patients breathe pure oxygen inside a sealed hyperbaric chamber, which simulates 2 to 2.5 atmospheres of pressure—similar to being 33 to 50 feet underwater.
Typically, the amount of oxygen transported by red blood cells is maxed out when a patient breathes ambient air. The pressurized chamber increases the amount of oxygen dissolved in the fluid around the tissues, allowing for more efficient oxygen delivery to sick tissues.
This prevents tissue death and promotes healing by stimulating growth hormones and stem cell production. It also kills bacteria that thrive in environments without oxygen.
What conditions does HBOT treat?
At Parkview's Center for Wound Healing, the most common injuries we treat with HBOT are diabetic foot ulcers and late changes from radiation therapy, such as radionecrosis (soft tissue) or osteonecrosis (bone tissue).
The current FDA-accepted indications for HBOT include:
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Air or gas embolism
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Arterial insufficiencies
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Central retinal artery occlusion
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Carbon monoxide poisoning
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Clostridial myonecrosis
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Compromised grafts of flaps
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Acute traumatic ischemia
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Decompression sickness
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Delayed radiation injuries
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Soft tissue radio necrosis
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Osteoradionecrosis
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Sudden sensorineural hearing loss
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Intracranial abscess
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Necrotizing soft tissue infections
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Refractory osteomyelitis
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Severe anemia
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Severe thermal burns
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Avascular necrosis (aseptic osteonecrosis)
Who is not a candidate for HBOT?
Before starting HBOT, patients undergo a consultation to identify any potential health risks or contraindications. This involves reviewing their medical history, listening to the heart and lungs and conducting chest X-rays and echocardiograms (EKG/ECG).
Contraindications and potential health risks that may make a patient unsuitable for HBOT include:
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Pneumothorax (collapsed lung)
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Flash pulmonary edema
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History of seizures
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Barotrauma
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Claustrophobia or confinement anxiety
What can patients expect from a typical HBOT session?
When patients arrive at one of our clinics for treatment, they are given a hospital-approved gown or scrubs to wear during therapy. They must remove all electronics and jewelry to avoid potential fire hazards.
Before entering the chamber, patients have their vitals recorded and their ears examined by the physician to check for any issues.
To begin treatment, the patient lies back on a stretcher that slides into a clear acrylic tube measuring about 7 ft (2.1 m) long and 25 in. (64 cm) across. The chamber is equipped with a two-way radio and a care team member is always near the phone if needed.
A typical session lasts about two hours and requires about 15 minutes at the start to gradually bring the patient to the target pressure, followed by approximately 90 minutes at full pressure. During this time, they may watch television or even take a nap. Once the session is complete, patients will spend 15 minutes in the tube while the pressure gradually returns to normal.
How does HBOT reduce healing times for those with chronic wounds?
Using diabetic foot ulcers as an example, in our clinics, HBOT has increased the likelihood of healing from 40-50% to 75% measured over 30 to 60 days. However, HBOT is an adjunctive or complementary therapy and should always be used with other standard wound care procedures and chronic disease management.
Our wound care clinics work closely with physician groups, including primary care providers, vein specialists, cardiologists, orthopedists and infectious disease providers. Together, we try to improve the overall health of the patient because chronic wounds are usually the result of suboptimal management of other underlying conditions.
Learn more
Parkview Centers for Wound Healing offer HBOT as adjunctive therapy, which does not require a physician referral. If you are dealing with a chronic wound or need additional information and support, contact any of our three locations for help.
