If you have a bone infection or a wound that’s not healing, your doctor might recommend hyperbaric oxygen (HBO) therapy. The treatment consists of breathing in pure oxygen in a pressurized chamber.
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Hyperbaric Medicine FAQs
Julie Bielec, MD, is medical director of the Wound and Hyperbaric Center of UPMC Western Maryland. She explains what hyperbaric oxygen therapy wound healing is, and who might benefit from this treatment.
Q: What is a hyperbaric chamber used for?
A: For years, doctors have used it to help scuba and deep-sea divers recover from rapid changes in pressure resulting in “the bends.” In the 1960s, they discovered it helped in treatment of carbon monoxide poisoning and gas gangrene. It’s exploded from there, and now there are 14 FDA-approved diagnoses for HBO therapy, including wound healing.
Q: How does HBO therapy help wounds to heal?
A: In room air, we breathe 21% oxygen, but in the HBO chamber we breathe 100% oxygen. The chamber also changes the atmospheric pressure, forcing more oxygen into the body. This increased oxygen causes the formation of new blood vessels, bringing more oxygen to the wound to help with healing.
Q: What are some other hyperbaric chamber benefits?
A: HBO therapy stimulates many growth factors in wounds. It increases production of collagen and skin cells to speed up healing times. HBO therapy also decreases localized inflammation and decreases inflammatory proteins that prevent wound healing.
Q: What kind of wounds would most benefit from HBO?
A: The most common reason we use HBO therapy is for bone infections called osteomyelitis. These often occur in people with diabetes or other circulation disorders. Osteomyelitis can also develop from a bone fracture or a deep puncture wound.
People with wounds that fail to heal after radiation treatments can also benefit from HBO therapy. You may have had radiation therapy for cancer and now have a wound or surgical incision that won’t heal. By increasing the oxygen to these areas, we are able to heal the wounds.
HBO therapy is also approved to treat:
- Air or gas embolism (when an air bubble enters a vein or artery).
- Carbon monoxide poisoning.
- Gas gangrene (a life-threatening soft tissue infection).
- Crush injuries (with extensive damage to soft tissue).
- Decompression sickness (dive accidents).
- Arterial insufficiencies (blood supply issues associated with previous surgery and oxygen deficiency).
- Severe anemia.
- Brain abscesses.
- Necrotizing soft tissue infections.
- Compromised skin grafts or flaps (after surgery).
- Thermal burns.
- Sudden sensorineural hearing loss (without any known cause).
Q: What should someone expect from an HBO therapy session?
A: After you arrive, you’ll change into cotton scrubs, and we’ll take your vital signs and test blood sugar. If they’re within normal limits, you’ll enter the chamber and start the 90-minute treatment.
The treatment is 30 minutes of pure oxygen, then 10 minutes of an air break. We’ll repeat this process two more times. The entire procedure takes about two hours.
For the break, you’ll stay in the chamber but wear a face mask that gives medical air at 21% oxygen. The break gives the brain a rest from 100% oxygen and prevents possible seizure activity.
Q: What is it like inside the chamber?
A: The chamber is completely closed and sealed for the treatment. It is mainly acrylic, so you can see your entire surroundings and not feel claustrophobic. You can lie on the gurney in any way that’s comfortable; you don’t need to keep still.
The treatment doesn’t cause pain. You may feel a slight increase or decrease in pressure (like when your ears “pop” on an airplane).
There is a screen above the chamber so you can watch television. You may also sleep.
Q: How many treatments do you usually need?
A: Most people receive therapy Monday through Friday. You’ll receive a minimum of 24 treatments and a maximum of 60 treatments. You may begin to see improvement in wound healing as quickly as three or four days.
Q: Do I need a referral to receive HBO therapy?
A: You don’t need a special referral. But a doctor needs to evaluate you and decide if HBO therapy is appropriate. (Some conditions, like chronic heart or lung disease, may pose too great a risk for HBO therapy.)
Q: Does insurance cover HBO therapy?
A: If you have one of the 14 approved medical conditions for HBO therapy, it is usually covered by most insurances. We will obtain authorization before starting the treatment.
Q: Is there anything else people should know about HBO therapy?
A: It works! We have had people on the verge of below-a-knee amputation who received wound care and HBO therapy. We were able to save their feet.
If people are willing to make the time commitment, HBO therapy can heal their wounds and save limbs.
Julie F. Bielec, MD, FACS
Medical Director, Wound and Hyperbaric Center, Wound and Hyperbaric Medicine
UPMC Western Maryland12502 Willowbrook Road Suite 360Cumberland, MD 21502
T 240-964-8711F 240-964-8716
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