Hyperbaric oxygen therapy for the management of chronic wounds: patient selection and perspectives

Enoch Huang,1 Marvin Heyboer III,2 Davut J Savaser11Hyperbaric Medicine and Chronic Wound Clinic, Legacy Emanuel Medical Center, Portland, OR, USA; 2Emergency Medicine, Division Chief, Hyperbaric Medicine & Wound Care, SUNY Upstate Medical University, Syracuse, NY, USAAbstract: The Undersea and Hyperbaric Medical Society includes “select problem wounds” as an accepted indication for the use of hyperbaric oxygen (HBO2), however, the treatment of diabetic foot ulcers (DFUs) has dominated any discussions of problem wounds because of the prevalence of DFUs in today’s patient population and the reimbursement available for their treatment. Other wound types (eg, calciphylaxis ulcers, sickle cell ulcers, and pyoderma gangrenosum) that have well-deserved reputations as problem wounds have been infrequently treated with HBO2. While there are sound fundamental reasons why additional oxygen may have benefits in the treatment of these wounds, the challenge is finding enough high quality evidence to support routine use of HBO2.Keywords: hyperbaric oxygen therapy, HBO2, oxygen, problem wounds, chronic wounds, wound healing, diabetic foot ulcers, arterial insufficiency ulcers, sickle cell disease, scleroderma, calciphylaxis, graft versus host disease, pyoderma gangrenosum, venous stasis ulcer