Under pressure Using hyperbaric oxygen therapy to heal chronic wounds

The aim of this thesis was to explore the efficacy of hyperbaric oxygen therapy (HBOT) on healing of chronic wounds, which is currently only common practice for diabetic wounds. To do this, an extensive population of patients with different kinds of chronic wounds, which was treated with HBOT, was analyzed.
In Current Practice, HBOT is primarily used to treat non-healing diabetic foot ulcers (DFUs). The physiological changes in diabetes that impair wound healing are described. Despite its daily usage, there is some debate about the efficacy of HBOT due to the high levels of amputations that are performed within this patient group. A possible explanation is the presence of arterial vascular disease, so two separate reviews of ischemic and non-ischemic DFUs are presented. Another reason for non-healing is a higher-grade wound. An analysis of 206 patients with a wound with exposed bone was done and provided positive results.
Looking at Expanded Possibilities, the results of applying HBOT for venous leg ulcer and two cases of orthopedic radiation ulcers are presented. To further explore the theory that not just diabetic, but all chronic wounds benefit from HBOT, the results of 774 HBOT treatment series for different wound types is explored. The last chapter explores the influence of nutritional status on healing.
This thesis concludes that not just diabetic, but all non-healing wounds may benefit from HBOT. At least 30 sessions are associated with a positive outcome. Recorded side effects of HBOT are usually mild and transient.