Non-healing wounds are those which fail to heal within a reasonable time frame despite adequate management. Although multifactorial in aetiology, these wounds are typically hypoxic which is where HBOT becomes very effective. The rationale for treatment of chronic non-healing wounds with HBOT uses the known secondary mechanisms of action. HBOT leads to improved angiogenesis through a multifactorial mechanism. First, fibroblast proliferation and collagen synthesis are oxygen dependent, and collagen is the foundational matrix for angiogenesis. In addition, HBOT likely stimulates growth factors, particularly vascular endothelial growth factor (VEGF), involving angiogenesis and other mediators of the wound healing process. Hyperbaric oxygen also has been shown to have direct and indirect antimicrobial activity; in particular, it increases intracellular leukocyte killing. Decreased oedema due to systemic vasoconstriction allows better diffusion of oxygen and nutrients through tissues while also relieving pressure on the surrounding vessels and structures.

 

Non-healing wounds where HBOT has been successfully used include diabetic foot ulcers, venous and arterial insufficiency ulcers. Diabetic lower extremity ulcers have been the focus of most wound research in hyperbaric medicine, since the aetiology of these wounds is multifactorial, and HBOT can address many of these factors. Several randomised controlled clinical trials have proven the beneficial effects of HBOT for the treatment of diabetic lower extremity wounds, apart from many prospective, non-controlled clinical and retrospective studies.

 

HBOT in diabetic wounds is used in conjunction with other wound management techniques including wound debridement, dressings, pressure-relieving strategies, appropriate glycaemic control, and nutrition and antibiotic management.

Hyperbaric oxygen therapy is a medical treatment which enhances the body's

natural healing processes by inhalation of 100% medical grade oxygen in a total body chamber,

where atmospheric pressure is increased and controlled. it is used for a wide variety

of treatments usually as part of an overall medcial care plan.

 

Under normal circumstances, oxygen is transported throughout the body only by red blood cells. With HBOT, oxygen is

Dissolved into all of the body's fluids, the plasma, the central nervous system fluids, the lympH, and the bone and can be

carried to areas where circulation is diminished or blocked. In this way, extra oxygen can reach all of the damaged

tissues and the body can support its own healing process. THe increased oxygen greatly enhances the ability of white

blood cells to kill bacteria, reduces swelling and allows new blood vessels to grow more rapidly

 

it is a simple, non-invasive treatment.