If you have severe, non-healing wounds, hyperbaric oxygen therapy may help, says Arti Masturzo MD, the medical director at the Bethesda North Wound Care Center.
Hyperbaric oxygen therapy, an advanced treatment option offered at Bethesda North Hospital, involves the use of a hyperbaric chamber to increase the amount of oxygen in the blood.
Hyperbaric Oxygen Therapy: How Does it Work?
Hyperbaric oxygen therapy allows a patient to breathe 100 percent oxygen, at two to three times greater than normal atmospheric pressure, causing oxygen to disperse into the blood plasma. This oxygen-rich plasma is then able to travel past the blocked blood vessels, and diffuse deeper into the damaged tissue, encouraging the formation of new blood vessels. As more blood vessels develop, the red blood cells start to circulate, delivering more oxygen to the affected area, creating an optimal environment for wound healing.
This therapy can help deeper, more severe wounds that are not healing with standard treatment options. “Hyperbaric oxygen is an adjunctive therapy. It does not replace good wound care,” Dr. Masturzo explains. “It acts as an adjunct to speed up healing, when used in conjunction with standard wound care.”
Hyperbaric therapy may be used to treat the following types of wounds:
- Diabetic Wounds of the Lower Extremities (DWLE)
- Soft Tissue Radionecrosis
- Compromised Flaps & Grafts
- Chronic Refractory Osteomyelitis
- Acute Peripheral Arterial Insufficiency
- Progressive Necrotizing Infections
- Crush Injuries
- Acute Traumatic Peripheral Ischemia
- Gas Gangrene
- Acute Carbon Monoxide Intoxication
- Decompression Illness/sickness
- Gas Embolism
- Cyanide Poisoning
What’s a Hyperbaric Oxygen Therapy Session Like?
Depending on the severity of your wound, your doctor may request you have anywhere from five to 80 sessions in the chamber. This therapy, which is performed on an outpatient basis, is typically scheduled for five days a week, with each session usually lasting between 90 to 120 minutes.
Because hyperbaric oxygen therapy often causes a drop in blood sugar, diabetics are instructed to eat before they come in for their session. Ideally, blood sugar levels should be at least 100 or 110 before entering the chamber. "We evaluate every patient for safety before they go in," Dr. Masturzo point out. Also, smokers are highly encouraged to quit smoking, or, at the very least, not smoke during the course of therapy, as it can counteract the benefits of this treatment.
During your session, as pressure in the hyperbaric oxygen therapy chamber increases, you may feel pressure in one or both ears (this is a common complaint). In order to maximize comfort, our technicians will teach you relaxation techniques before your first session. In some cases, our doctors will require that you get an ear tube placed in the problematic ear (or ears), in order to provide the highest level of safety and comfort. You may also watch television, adjust your bed, and communicate with your technician.
Hyperbaric Oxygen Therapy: Is it for Me?
If you have certain medical conditions, like lung disease or heart disease, or are pregnant, your doctor will not prescribe this type of therapy. While most pacemakers are okay, some implantable devices – for example, certain spinal cord stimulators – are not permitted to enter the chamber. Similarly, “if we don’t know the safety of something, we tend to not take risks,” Dr. Masturzo points out.