Hyperbaric Oxygen Therapy | Wound Healing

A nurse talks with a patient in a hyperbaric oxygen therapy chamber.

For wounds and other conditions that will not heal through traditional treatments, hyperbaric oxygen therapy (HBOT) can help. This treatment involves breathing 100 percent oxygen at two to three times the normal air pressure in a pressurized enclosed chamber. It is an advanced, FDA-approved treatment option for several health conditions, including:

Air or gas embolism
Anemia in patients who cannot receive blood transfusion
Thermal burns
Carbon monoxide poisoning
Decompression illness
Diabetic foot ulcers and select other non-healing wounds
Gas gangrene and necrotizing soft tissue infections
Sudden sensorineural hearing loss (sudden or unexplained loss of hearing)
Chronic refractory osteomyelitis (skin & bone infections)
Compromised skin grafts or flaps
Delayed radiation bone or soft tissue injuries
Central retinal artery occlusion (vision loss)

We offer hyperbaric oxygen therapy in both Maryland and Washington, D.C. In fact, the MedStar Health Wound Healing Institute at MedStar Georgetown University Hospital is the only wound care clinic in Washington, D.C. accredited by the Undersea and Hyperbaric Medical Society and has been accredited with distinction since 2020. This is a testament to our commitment to providing the highest standards for care quality and patient safety. Our dedicated team of technicians, nurses, and physicians have special training in HBOT, leading to a high healing success rate, exceptional patient care, and unparalleled attention to safety and quality.

What is hyperbaric oxygen therapy?

Hyperbaric oxygen therapy (HBOT) is a treatment in which patients breathe 100% oxygen while pressurized to a depth greater than sea level. The use of hyperbaric pressure as a treatment for medical conditions dates back to the 1600’s, before the discovery of oxygen. While many people are familiar with the use of this therapy for decompression illness (“the bends”) in scuba divers, this therapy is also used for other medical conditions, such as treating carbon monoxide poisoning and healing diabetic wounds.

How does it work?

The air we normally breathe is 21 percent oxygen and 78 percent nitrogen. Patients who receive hyperbaric oxygen therapy breathe 100 percent oxygen under pressure. Breathing pure oxygen effectively delivers an increased supply of oxygen to your body’s tissues. For patients with non-healing wounds, the extra oxygen can result in new blood vessel formation and faster wound healing.

In addition, this treatment can enhance antibiotic activity, reduce certain inflammatory processes in the body, and increase oxygen levels in tissues that have been deprived of oxygen. As a result, use of this therapy and other treatments may save a limb from needing amputation.

What is a hyperbaric chamber?

A hyperbaric oxygen chamber is a device used to administer hyperbaric oxygen therapy. Hyperbaric chambers are generally cylindrical in shape and are composed of steel and clear acrylic. We have four hyperbaric chambers in each of our two hyperbaric oxygen therapy locations in the Mid-Atlantic region. Each chamber is designed to accommodate one patient (monoplace hyperbaric chambers). Both adults and children can be easily treated in monoplace hyperbaric chambers.

Our hyperbaric chambers are 41 inches in diameter, allowing for greater patient comfort during the hyperbaric treatment process. The hyperbaric chambers have communication systems to allow patients to talk back and forth with the hyperbaric medicine staff, so patients are never alone during the treatment process.

What should I wear and bring into the hyperbaric chamber?

Patients must wear garments containing at least 50% cotton in the hyperbaric environment. At MedStar Health, we provide comfortable robes for our hyperbaric patients to wear during each treatment. Patients must remove jewelry, lotions, deodorants, hair products, and certain types of eyeglasses before each treatment.

To maximize patient safety, patients are not allowed to bring cell phones, tablets, books, magazines, or other personal belongings into the hyperbaric chamber. Patients may watch a movie during the treatment. Some patients prefer to sleep or meditate during this time.
How many hyperbaric treatments will I need?

The number of treatments required differs for each patient, as different conditions are treated with different numbers of treatments. For wound healing purposes, many patients receive 20 to 40 treatments. Patients with carbon monoxide poisoning or decompression illness may require only two or three treatments. Hyperbaric treatments are generally administered once a day, Monday through Friday. Weekend treatments may also be available for patients who require treatments on an urgent or emergent basis.
Does insurance cover the use of this therapy?

Health insurance companies consider hyperbaric oxygen therapy to be medically necessary for most or all the conditions listed above. As each insurance company has a different list of conditions considered medically necessary for treatment, we encourage patients to confirm with their own insurance company whether HBOT is covered for their diagnosis. The hyperbaric medicine staff will obtain preauthorization, if needed, before the start of treatments. Patients are responsible for any insurance deductibles or copays associated with each treatment.
Is this therapy dangerous?

When administered correctly, HBOT is a safe procedure with minimal adverse effects. However, just like any other medical procedure, there are risks associated. A physician is present and immediately available in the treatment area during each session to assist with any complications that may arise.
What are the possible side effects of this treatment?
Side effects are rare and generally preventable. However, possible complications may include the following:

Middle ear barotrauma (“ear squeeze”) is the most common complication of HBOT. This is similar to the “popping” sensation or ear fullness that can occur during the landing process on an airplane. This sensation is generally self-limited and can be prevented by carefully instructing patients on appropriate ear pressure equalization techniques.

Oxygen toxicity, which may result in seizures, occurs in very rare instances. However, our hyperbaric medicine staff uses careful techniques to prevent oxygen toxicity, and as a result, seizures are extremely uncommon.

In diabetic patients, hyperbaric pressurization may result in hypoglycemia (low blood sugar).

Some patients may experience a temporary change in their visual acuity during their hyperbaric treatment course.

Patients with a history of anxiety or claustrophobia may exhibit confinement anxiety during hyperbaric treatments.

Finally, as the hyperbaric environment is oxygen-enriched by definition, fire safety is of the utmost importance. Your hyperbaric medicine physician will discuss these side effects with you in detail during your initial hyperbaric medicine consultation.