Hyperbaric oxygen therapy (HBOT) is the medical use of oxygen in a pressurized environment, at a level higher than 1 atmosphere absolute (ATA). Increased pressure allows for oxygen to dissolve and saturate the blood plasma (independent of hemoglobin/red blood cells), which yields a broad variety of positive physiological, biochemical and cellular effects. This noninvasive therapy is the most trusted way to increase oxygen levels to all organs of the body. The typical treatment lasts for 60-90 minutes, during which the patient lies down and breathes normally.
HBOT has been demonstrated in several clinical studies to enhance the body’s innate ability to repair and regenerate. It is used as an adjunct therapy to complement and enhance the healing process in both chronic and acute conditions.
A chronic wound is a disruption in the body’s tissue that is most commonly associated with the loss of skin and the underlying tissue, the loss of muscle, or the loss of bone. When there is a lack of oxygen it makes it difficult for the wound to heal. Hyperbaric Oxygen therapy makes it easier to see what tissues may need to be removed, lessens the chance of infection, promotes growth of new tissue and encourages bone repair.
Wound healing is a complicated process. Many different steps need to take place in order for a complete healing process to occur. Whether the wound is hypoxic or ischemic such as diabetic wounds, venous stasis ulcers, failing grafts or flaps, necrotizing soft tissue infections or refractory osteomyelitis, two basic staples are needed for healing – sufficient oxygen supply and perfusion of oxygen to the affected tissues. Increased oxygen tension is a major controlling factor in killing bacteria, resistance to infection, collagen production, new blood vessel growth, and new skin generation. In wounds with low oxygen levels, some or all of these processes are impaired. HBOT helps in the healing process by stimulating the cells which create new blood vessel (capillary) growth. These new vessels are created in the wound area, allowing for nutrient enriched blood to reach the area of the body which requires healing.
Angiogenesis, or new blood vessel growth, generally occurs around the 20th HBOT treatment. Increased oxygen is also needed in the creation of collagen and new skin growth, which are both necessary in the healing process. In the outer areas of a wound, oxygen levels are decreased. The lack of oxygen makes these areas prime targets for bacterial growth.
By increasing oxygen levels, bacteria are killed off and the body is able to stave off infection. Hyperbaric oxygen therapy helps in the recovery of oxygen-compromised wounds. The therapy helps revive cells in viable tissue, allowing for a more complete healing of the affected area. HBOT treatments are performed at 1.3 ATA for 60 minutes of oxygen breathing.
Information provided by Hyperbaric Medicine Practice, Second Edition Revised – Eric P. Kindwall, MD and Harry T. Whelan, MD.
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