By Michael Manuel, MD
Wound Care Solutions
"I was told to go to a wound care center for my diabetic foot infection and that I may benefit from hyperbaric oxygen therapy. What is hyperbaric oxygen therapy?"

Hyperbaric oxygen therapy (HBOT) is a medical treatment that increases the amount of oxygen in a patient's blood. HBOT involves breathing pure oxygen in a pressurized environment.

This is done by pressurizing a chamber to 2-3 times sea-level air pressure and breathing 100% oxygen. Under these conditions, you can significantly increase the amount of oxygen in your body up to 10 times more than normal. This large increase in oxygen improves the amount that reaches tissue that would otherwise not get enough oxygen to heal.

Along with the increase in oxygen, HBOT stimulates the release of substances called growth factors and stem cells, which promote healing. Other cells that fight infection are also stimulated to kill bacteria.

People with certain types of chronic wounds/ulcers may not have an adequate supply of oxygen to the damaged tissue to allow healing to happen normally. When this is the case, HBOT is usually able to temporarily increase blood oxygen levels towards normal levels to improve tissue perfusion and promote healing and fight infection.

A typical treatment lasts approximately 90 minutes, with most people receiving between 20-40 treatments. HBOT is done along with concurrent treatment in a wound center. These treatments include localized wound care, surgical debridement to remove infected tissue, improving nutrition levels and procedures to re-open or replace occluded blood vessels.

There are a variety of indications for utilizing HBOT in the treatment of non-healing wounds and other medical problems. Most wound centers will treat patients suffering from chronic issues, including diabetic foot ulcers, chronic osteomyelitis (bone infection), ulcers present after revascularization, failing skin/flaps, radiation injury and osteoradionecrosis.

Some other emergent reasons for HBOT include carbon monoxide poisoning, decompression sickness, a crush injury, gangrene, burns and severe anemia.

There are two main ways of receiving HBOT. A monoplace chamber designed to treat one person at a time, where patients are placed on a bed in the chamber and pressurized using 100% pure oxygen.

Or the multiplace chamber, designed to have up to 10 patients per treatment. These use room air pressurized to the appropriate pressure, and each patient breaths 100% oxygen in a hood placed over their head. Which treatment you get depends upon what each institution has.

If you have a wound that hasn't healed in four weeks, you should consult your family doctor or seek your local wound care center's assistance. A wound care specialist will see you. A specialized treatment plan will be developed to help start the healing process.

If appropriate, this care may include hyperbaric oxygen therapy.