A sore that will not close can quietly take over daily life. You change dressings, watch for redness, worry about infection, and wonder why something so small is taking so long. For people with chronic wounds, that worry is real, and so is the search for options that may help the body finish the job it has started.
Hyperbaric oxygen therapy, often shortened to HBOT, is one of those options. It is not right for every wound, but for certain kinds it can be a useful addition to standard care. This article explains what it is, who may benefit, and what to discuss with your doctor.
What Is Hyperbaric Oxygen Therapy?
In HBOT, a person breathes pure oxygen while inside a pressurized chamber. The air pressure is raised to about two to three times normal atmospheric pressure. Under these conditions, the lungs can take in far more oxygen than usual, and the blood plasma carries that oxygen to tissues, not only the red blood cells.
Sessions are typically painless. Many people feel a fullness in the ears, similar to the feeling during a plane descent, as the pressure changes. A course of treatment usually involves a series of sessions over several weeks, and the exact plan is set by the treating team.
Why Oxygen Matters for Healing
Wound repair is demanding work. Cells must multiply, new blood vessels must form, and collagen must be laid down to rebuild tissue. All of this requires oxygen. In a wound with poor blood flow, the tissue at the center can become starved of oxygen, and healing stalls.
Higher oxygen levels in the blood may help in several ways:
- Supporting the growth of new small blood vessels in damaged tissue
- Helping white blood cells fight certain bacteria more effectively
- Encouraging cells that build new connective tissue
- Reducing swelling that can limit blood flow to the wound
Who May Benefit
HBOT is generally considered for wounds that have not responded to standard care, or where tissue is at risk. Conditions commonly discussed include:
- Diabetic foot ulcers that have not improved after a period of good wound care
- Tissue damage following radiation treatment
- Certain serious or deep infections of bone or soft tissue
- Compromised skin grafts or flaps
- Some crush injuries and other wounds with reduced blood supply
Chronic wounds are especially common in people with diabetes, vascular disease, limited mobility, or long-term pressure on the skin. Older adults are also at higher risk.
What Does the Research Show?
The evidence is strongest for diabetic foot ulcers, where several studies and reviews suggest HBOT added to standard care can improve healing and may lower the chance of major amputation in some patients. Evidence is also well established for radiation-related tissue injury. For other wound types, the research is mixed or limited, and results vary from person to person.
This is why HBOT is viewed as an add-on, not a replacement. Core wound care still comes first: keeping pressure off the area, managing blood sugar, treating infection, cleaning and dressing the wound properly, and addressing circulation problems.
Possible Risks and Limits
HBOT is generally well tolerated, but it carries some risks. Ear pressure or discomfort is the most common. Less often, people experience temporary changes in vision, sinus pain, or, rarely, lung effects or oxygen-related seizures. Certain conditions, such as an untreated collapsed lung, require careful review before treatment. Tell your doctor about all medications and health conditions, and never smoke around treatment, as smoking also reduces oxygen delivery to tissues.
Questions to Ask Your Doctor
- Is my type of wound one where HBOT has good supporting evidence?
- Which standard treatments should I be doing alongside it?
- How many sessions might be needed, and how will progress be measured?
- What risks apply to me given my other health conditions?
Taking the Next Step
If a wound has not improved, or you notice warning signs such as spreading redness, increasing pain, drainage with odor, or fever, seek medical attention promptly. Early evaluation gives you more options. If you would like to talk through your concerns, the practice of Aldo Gamarra, MD in Lancaster, CA can be reached at (661) 579-6088.