Hyperbaric Oxygen Treatment (HBOT) for the Healing of Wounds

The quest for innovative therapies to address complex medical conditions is ongoing. Among these advancements, Hyperbaric Oxygen Therapy (HBOT) has emerged as a promising modality for wound healing. HBOT offers a noninvasive approach to enhance tissue oxygenation and expedite the healing process by Harnessing the therapeutic potential of oxygen delivered at increased atmospheric pressure.

Chronic wounds, characterized by impaired healing and prolonged inflammation, present a formidable challenge to patients and healthcare providers. Whether stemming from traumatic injuries, surgical procedures, or underlying medical conditions such as diabetes, these wounds often defy conventional treatment modalities, leading to significant morbidity and healthcare expenditure.



Hyperbaric Oxygen Treatment (HBOT) for the Healing of Wounds

In nations like Australia, where national policy does not fund treatment for chronic wounds, the cost of care falls on the individual. In contrast, it places a significant financial strain on the nation's healthcare systems, where government funding is provided. Furthermore, research indicates that those with chronic wounds experience a lower quality of life for a more extended period. People who are afflicted have ongoing distress as a result of the protracted healing process and scar formation, which also affects their performance. The following wound types are included in the category of chronic wounds:

  • Burns from heat
  • Skin grafts and flaps
  • inflammation of soft tissues
  • diabetic injuries
  • Radiation wounds
  • Crush wounds
  • Rheumatism

The two main factors contributing to a delay in wound healing are lack of oxygenation and infection. Wound healing can be hastened if the partially wounded cells at the wound site receive enough oxygen. HBOT is a noninvasive technique that guarantees the injured tissue region receives a raised pressure and a high oxygen concentration (60 mL/L plasma oxygen level at 95% oxygen and 2 ATA pressure). Therefore, in addition to antibiotic treatment, powerful adjuvant therapy is used to enhance wound healing, hasten angiogenesis, eliminate toxins, initiate neovascularization, and activate the repair genes. Wound healing is one of the approved uses of this therapy, and it has established safety and efficacy, according to the Undersea and Hyperbaric Medicine Society (UHMS), an international body that authorizes its use for various medical diseases.

 INTRODUCTION

Chronic nonhealing wounds pose a significant healthcare challenge, leading to escalating costs and substantial morbidity. Lazarus and colleagues define chronic wounds as failing to progress through a timely healing process to achieve anatomical and functional integrity or undergoing repair without sustaining lasting results. In the Netherlands, approximately 5.4% of nursing home residents and 3.7% of individuals receiving homecare services suffer from chronic wounds, highlighting the widespread nature of this issue. Complications such as infection often arise, increasing morbidity and frequently culminating in lower extremity amputation. Additionally, chronic wounds detrimentally impact quality of life, contributing to pain, sleep disturbances, and reduced mobility.

Mustoe and colleagues identify diabetic foot, venous, and pressure ulcers as the predominant types, collectively comprising over 90% of all wounds. Despite their varied etiologies, these wounds share common contributing factors that predispose them to chronicity, including ischemia, advanced patient age, ischemia/reperfusion injury, and bacterial contamination. Recognizing and addressing these factors are essential in managing and preventing chronic wounds, thereby improving patient outcomes and reducing the burden on healthcare systems.

HBOT mainly has two effects on wound healing:

Excess oxygen

Reducing the size of the bubble

Increased partial pressure and raised plasma oxygen level are referred to as hyperoxygenation. Henry's law is being applied in this case. Crush injuries, flaps and grafts, compartment syndrome, and acute blood loss anemia can all be effectively treated with hyperoxygenation.

Boyle's law, which states that increased pressure causes a drop in bubble volume, supports the idea of smaller bubbles. It is most effective for atrial gas embolism and decompression sickness.

METHODS

All patients with chronic nonhealing wounds referred to our clinic from 2013 to 2016 who underwent a minimum of 20 HBOT sessions were prospectively evaluated. Patients were referred from various specialisms, including vascular surgery, plastic surgery, and orthopedic surgery. Before referral, a thorough vascular examination had been conducted, and if arterial or venous vascular disease was found, revascularization was performed, if possible. Patients were only referred if no sufficient healing (at least three months taken as the standard) was observed after optimal wound care by the national guidelines (www.wcs.nl) or if a wound deteriorated dramatically and the stepped care principle was no longer an option.

Among the secondary wound-healing mechanisms are:

Angiogenesis: While anoxia promotes angiogenesis, the amount of oxygen our tissues receive determines neovascularization and the development of the capillary network. Increasing the oxygen gradient between blood plasma and hypoxic tissues with hyperbaric oxygen therapy in HBOT chambers promotes blood vessel development.

Vasoconstriction: Hyperoxia causes vasoconstriction in normal cells, which reduces the likelihood of post-traumatic edema. However, HBOT compensates for the effect by providing a high concentration of blood plasma oxygen; therefore, it does not produce hypoxia.

Oxygen is essential for the hydroxylation of proline and lysine residues during collagen production. For wound healing, collagen must mature and crosslink, and HBOT encourages these processes. Mature collagen deposition accelerates the healing process.

Oxidative death of WBCs: Oxygen free radicals produced by HBOT oxidize proteins and membrane lipids, damage DNA, and obstruct bacterial metabolism. HBOT primarily functions against anaerobic bacteria lacking superoxide dismutase, and it also activates the oxygen-dependent peroxidase that WBCs use to destroy germs. Moreover, it sets off the scavengers of oxygen radicals, which eliminate the offending molecules and carry on the healing process.

WELCOME TO YILONG OXYGEN THERAPY CENTER

YILONG Medical caters to a diverse clientele, including individual households, professional health and beauty centers, clinical facilities, athletes, and patients who use wheelchairs. Our comprehensive range of hyperbaric chambers caters to various needs, including portable chambers suitable for lying down and sitting positions, hard-shell chambers, and wheelchair-accessible models.

At YILONG, we prioritize quality assurance. All materials are subjected to rigorous 100% testing to ensure the highest standards of production and procurement. Our commitment to reliability and responsiveness underscores our dedication to superior products and exceptional customer service.

Proliferation of fibroblasts: Fibroblasts are essential for tissue repair from the late inflammatory stage until the ultimate epithelization. HBOT activates stem cells and upregulates repair factors to increase fibroblast proliferation and enhance cell migration for tissue regeneration.

Detoxification: The hypertoxic conditions brought on by HBOT prevent Clostridium from producing toxins and promote the passage of antibiotics over the bacterial cell membrane.

Boost immunity: The skin acts as a physical barrier to keep the outer environment out of the tissues beneath it. Secondary infection is the leading cause of chronic wound development. HBOT increases the amount of WBCs and stimulates the mobilization of stem cells and blood cell proliferation. WBCs are the primary immune system cells in the body. By strengthening immunity, HBOT aids the body's defenses against microbial invasion at the injury site.

Hyperbaric Oxygen Chamber Types

Depending on how many people can fit within, there are two different kinds of chambers.

Hyperbaric oxygen chambers are known as monoplane chambers in which a single person may only fit inside by sliding into the chamber. The individual is exposed to a high concentration of compressed oxygen within the chamber.

Multiplane hyperbaric chambers: These are hyperbaric chambers designed to accommodate multiple individuals. People can breathe in highly concentrated, compressed oxygen by donning masks. A medical expert could also be in the room to further assist the users.

How Long is Therapy?

Depending on the user's medical history and the state of the wound, the therapy could take one to three hours each time. Similarly, the number of sessions is also determined by the injury's stage and rate of healing.

How Should the Hyperbaric Chamber be Chosen?

Selecting a hyperbaric oxygen chamber is crucial for anyone thinking about self-directed therapy without medical assistance. If you select therapeutic HBOT, however, medical professionals handle everything. Oxymel hyperbaric chambers are unique in their quality, simplicity of use, intuitive interface, 100% efficiency, and efficacy.

Safety Precautions

Trauma to the middle ears is the most frequent problem linked to HBOT. Therefore, unless directed by a physician, a patient who has recently had ear surgery, the flu, a cold, a fever, or sinus or lung issues should not take HBOT. Therapeutic HBOT should only be taken on a medical professional's advice.

Frequently Asked Questions

What is Hyperbaric Oxygen Treatment (HBOT)?

Hyperbaric Oxygen Therapy (HBOT) involves breathing pure oxygen in a pressurized chamber, typically at higher than atmospheric pressure. This therapy increases the amount of oxygen delivered to tissues to promote wound healing and treat various medical conditions.

How does HBOT promote wound healing?

HBOT enhances wound healing by increasing tissue oxygenation, promoting angiogenesis (formation of new blood vessels), reducing inflammation, and enhancing the body's immune response. These effects contribute to accelerated tissue repair and improved wound closure.

What types of wounds can HBOT treat?

HBOT is effective in treating a wide range of wounds, including diabetic foot ulcers, venous ulcers, pressure ulcers, burns, radiation injuries, and traumatic wounds. It is particularly beneficial for chronic wounds that have failed to respond to conventional treatments.

What is the process of HBOT like?

During HBOT, patients enter a hyperbaric chamber where they breathe pure oxygen at increased pressure. The treatment typically lasts one to two hours per session, and the number of sessions varies depending on the severity and type of wound being treated.

Is HBOT safe?

When administered by trained medical professionals, HBOT is considered safe. However, some individuals may experience mild side effects such as ear discomfort or temporary vision changes. It is essential to undergo a thorough medical evaluation before starting HBOT to ensure it is appropriate for you.

How long does it take to see results with HBOT?

The timeline for seeing results with HBOT varies depending on factors such as the type and severity of the wound, the patient's overall health, and the frequency of HBOT sessions. Some patients may experience improvement after just a few sessions, while others may require more prolonged treatment.

Can HBOT be used in conjunction with other wound treatments?

Yes, HBOT can be used alongside other wound treatments, such as wound debridement, dressings, and antibiotics. HBOT is often used as an adjunctive therapy to enhance the effectiveness of conventional wound care approaches.

Does insurance cover HBOT?

HBOT coverage varies depending on factors such as the patient's insurance plan, the indication for treatment, and local healthcare regulations. Some insurance plans may cover HBOT for specific medical conditions, while others require prior authorization.

Are there any contraindications for HBOT?

While HBOT is generally safe, there are some contraindications, including untreated pneumothorax (collapsed lung), certain types of ear conditions, and certain medications that increase the risk of oxygen toxicity. Discussing your medical history with your healthcare provider before undergoing HBOT is essential.

Where can I receive HBOT treatment?

HBOT is available at specialized medical facilities equipped with hyperbaric chambers. These facilities may include hospitals, wound care centers, and specialized clinics. It is essential to seek treatment from a reputable facility with trained medical staff experienced in administering HBOT for wound healing.

Conclusion

FDA and UHMS have approved HBOT's effectiveness for wound healing. In addition to supplying oxygen to the injured area, hyperoxygenation encourages vascularization, lowers inflammation, gets rid of toxins, prevents subsequent infections because of its bacteriostatic and bactericidal properties, and grows angiogenesis. HBOT has been utilized to treat a variety of chronic wounds, including burns, ulcers, diabetic wounds, gangrene, and others, according to a number of clinical reports.

Hyperbaric Oxygen Treatment (HBOT) has emerged as a transformative intervention in wound care, offering new avenues for healing and improved patient outcomes. HBOT addresses the underlying pathophysiological processes that impede wound healing by enhancing tissue oxygenation, promoting angiogenesis, and mitigating inflammation. As a noninvasive and well-tolerated therapy, HBOT holds promise for individuals suffering from chronic wounds, including burns, diabetic ulcers, and radiation injuries.

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