How Hyperbaric Oxygen Therapy Accelerates Healing

What Is Hyperbaric Oxygen Therapy?

Hyperbaric oxygen therapy (HBOT) is an FDA-approved medical treatment in which patients breathe 100% pure oxygen while inside a pressurized chamber. The atmospheric pressure inside the chamber is increased to 1.5 to 3 times higher than normal air pressure, allowing your lungs to gather significantly more oxygen than would be possible at normal pressure.

This oxygen-rich blood then travels throughout your body, delivering healing benefits to tissues that are struggling to repair themselves due to injury, infection, or poor circulation.

The Science Behind HBOT

Under normal conditions, oxygen is transported through the body by red blood cells. However, HBOT allows oxygen to dissolve directly into all body fluids, including plasma, central nervous system fluids, lymph, and bone. This dramatically increases oxygen delivery to tissues—up to 10-15 times the normal amount.

The increased oxygen concentration provides several therapeutic effects:

• Enhanced white blood cell function: Oxygen-dependent killing of bacteria is improved, helping fight infection
• New blood vessel formation: HBOT stimulates angiogenesis, the growth of new blood vessels in areas with reduced circulation
• Reduced swelling: The increased pressure helps reduce edema by constricting blood vessels while still delivering more oxygen
• Collagen production: Fibroblast activity increases, promoting the formation of new connective tissue
• Stem cell mobilization: HBOT increases the release of stem cells from bone marrow, which aid in tissue repair

Conditions Treated with HBOT

HBOT is approved by the FDA and covered by Medicare and most insurance companies for the following conditions:

• Diabetic wounds: Particularly diabetic foot ulcers that have not responded to standard treatment
• Radiation tissue damage: Soft tissue and bone damage from radiation therapy (radiation necrosis)
• Chronic bone infections: Osteomyelitis that is refractory to standard treatment
• Compromised skin grafts and flaps: Improving survival of grafts in areas with poor circulation
• Crush injuries: Severe soft tissue injuries with swelling
• Gas gangrene: Serious bacterial infection requiring urgent treatment
• Arterial insufficiency ulcers: Wounds caused by poor arterial blood flow
• Carbon monoxide poisoning: Emergency treatment to displace carbon monoxide from hemoglobin

What to Expect During Treatment

Before Your Session

Before beginning HBOT, you'll receive a thorough evaluation to ensure the treatment is appropriate for your condition. You'll be advised to:

• Avoid alcohol and carbonated beverages for several hours before treatment
• Refrain from smoking, as it reduces the body's ability to transport oxygen
• Wear comfortable, cotton clothing (synthetic materials are not allowed in the chamber)
• Remove all jewelry, watches, and electronic devices
• Inform staff of any changes in medications or health status

During the Session

A typical HBOT session lasts about 90 to 120 minutes. Here's what happens:

1. Compression: The chamber is gradually pressurized over 10-15 minutes. You may feel fullness in your ears, similar to flying or diving.
2. Treatment: Once at pressure, you simply relax and breathe normally. Many patients read, watch TV, or nap.
3. Decompression: The pressure is slowly reduced over 10-15 minutes at the end of the session.

After Treatment

Most patients feel no different after treatment, though some report temporary changes in vision or mild fatigue. These effects typically resolve quickly. You can return to normal activities immediately after your session.

Treatment Protocol

The number of HBOT sessions needed depends on your specific condition:

• Diabetic wounds: Typically 20-40 sessions
• Radiation injury: Usually 20-40 sessions
• Chronic osteomyelitis: Often 40+ sessions combined with surgery and antibiotics
• Compromised grafts: May require only 10-20 sessions

Sessions are typically scheduled once or twice daily, five days per week. Consistency is important, as the benefits of HBOT are cumulative.

Safety and Side Effects

HBOT is generally very safe when administered by trained professionals. The most common side effect is temporary ear discomfort due to pressure changes, similar to what you might experience during air travel.

Less common side effects may include:

• Temporary nearsightedness (myopia) that typically resolves within weeks after treatment ends
• Fatigue after sessions
• Lightheadedness
• In rare cases, oxygen toxicity seizures (very rare at therapeutic pressures)

Certain conditions may preclude HBOT, including untreated pneumothorax (collapsed lung), certain medications, and some types of lung disease. Your physician will screen for these conditions before recommending treatment.

Is HBOT Right for You?

If you have a chronic wound that hasn't responded to conventional treatment, HBOT may be an effective option. The therapy works best as part of a comprehensive wound care program that may include debridement, advanced wound dressings, and management of underlying conditions.

Our board-certified wound care specialists can evaluate your condition and determine whether hyperbaric oxygen therapy is appropriate for your situation.