Problem wounds are defined
as non-healing wounds resistant to established management: surgery, antibiotics, and wound care. These chronic wounds are
usually seen in diabetic feet and legs, compromised amputations, non-healing traumatic wounds, radiation-induced damage, and
wounds where there is vascular insufficiency.
Hyperbaric oxygenation therapy
(HBOT) is useful where sufficient blood flow exists to increase the partial pressure of oxygen (pO2) in tissues
to a tension greater than 600 mg of mercury (Hg) when a person is under hyperbaric oxygen conditions. Transcutaneous Oximetry
measures the effect of hyperbaric oxygen around the wound site.
Medicare and many insurance
companies will reimburse for HBOT for diabetic wounds classified as Wagner Grade III refractory wounds resistant to healing
after 6 months of traditional wound-care management. Many insurers also cover other types of problem wounds.
Hyperbaric oxygenation therapy for chronic wounds:
· Increases oxygen to tissues
· Increases diffusion gradient
· Enhances immune system function for
removal of dead tissue
· Enhances bone formation
· Enhances collagen production for
repair of tissues
· Is most effective in diffuse micro-vascular
· Requires sufficient arterial flow
to the extremity
Although hyperbaric oxygen
for wound healing is generally covered by insurance, wounds must be evaluated every 30 days and must demonstrate some degree
of healing for continued coverage.
Suggested treatment schedule:
One daily treatment, five
days/week over a 30-day span, followed by wound reevaluation. Additional treatments scheduled as necessary. Individual responses