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Exploring the Healing Potential of Hyperbaric Oxygen Therapy (HBOT) for Sores, Injuries, and Non-Healing Wounds

Updated: Mar 24

Hyperbaric Oxygen Therapy (HBOT) has emerged as a promising therapeutic modality for a wide range of medical conditions, including the treatment of sores, injuries, and non-healing wounds. By delivering oxygen at increased pressure levels, HBOT enhances tissue oxygenation, promotes angiogenesis, and stimulates wound healing processes. In this article, we delve into the mechanisms of action underlying HBOT's healing effects and explore the clinical evidence supporting its efficacy in addressing these challenging conditions.

Understanding Sores, Injuries, and Non-Healing Wounds:

Sores, injuries, and non-healing wounds represent diverse clinical entities, ranging from pressure ulcers and diabetic foot ulcers to traumatic injuries and surgical wounds. Despite advances in wound care management, these conditions often present therapeutic challenges due to impaired tissue perfusion, chronic inflammation, and underlying comorbidities such as diabetes and vascular disease. Conventional treatment approaches may include wound debridement, topical dressings, and antibiotics, but many cases remain refractory to standard therapies, leading to prolonged healing times and increased morbidity.

Mechanisms of Action of HBOT:

HBOT involves the administration of 100% oxygen at increased atmospheric pressure levels, typically ranging from 1.5 to 3 atmospheres absolute (ATA). Under hyperbaric conditions, the solubility of oxygen in the bloodstream is markedly increased, leading to elevated oxygen tensions in the plasma and tissues. This oxygen-rich environment exerts multiple beneficial effects on the wound healing process:

  1. Enhanced Oxygen Delivery: HBOT increases the oxygen tension in ischemic tissues, overcoming oxygen diffusion limitations and promoting cellular respiration. Oxygen is a critical substrate for numerous cellular processes involved in wound healing, including collagen synthesis, angiogenesis, and microbial killing.

  2. Angiogenesis Stimulation: HBOT stimulates the formation of new blood vessels (angiogenesis) in ischemic tissues, improving tissue perfusion and oxygenation. This neovascularization enhances nutrient delivery to the wound site and facilitates the removal of metabolic waste products, supporting the proliferation and migration of fibroblasts and keratinocytes.

  3. Reduction of Edema and Inflammation: HBOT attenuates tissue edema and inflammation by modulating inflammatory cytokine production, reducing leukocyte adhesion and endothelial permeability, and enhancing lymphatic drainage. By mitigating tissue swelling and inflammatory cell infiltration, HBOT creates a more favorable microenvironment for tissue repair and regeneration.

  4. Antimicrobial Effects: HBOT exhibits direct antimicrobial activity against anaerobic and facultative anaerobic bacteria, including common wound pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa. By increasing oxygen tension in infected tissues, HBOT enhances leukocyte oxidative killing mechanisms and potentiates the activity of certain antibiotics, leading to more effective microbial clearance.

Clinical Evidence and Benefits:

A growing body of clinical evidence supports the efficacy of HBOT in promoting wound healing and tissue repair in various clinical settings. Randomized controlled trials, systematic reviews, and meta-analyses have demonstrated the following benefits of HBOT for sores, injuries, and non-healing wounds:

  1. Accelerated Wound Healing: Several studies have shown that HBOT reduces healing times and increases the rate of wound closure in patients with chronic ulcers, traumatic injuries, and surgical wounds.

  2. Resolution of Infection: HBOT has been shown to eradicate bacterial biofilms, enhance leukocyte-mediated bacterial killing, and improve tissue oxygenation in infected wounds, leading to reduced microbial burden and resolution of infection.

  3. Preservation of Tissue Viability: HBOT helps preserve tissue viability in ischemic or compromised wounds by promoting neovascularization, reducing tissue necrosis, and enhancing cellular metabolism.

  4. Prevention of Amputation: In patients with diabetic foot ulcers and other ischemic wounds, HBOT has been associated with a lower risk of major amputation and improved limb salvage rates.

  5. Quality of Life Improvement: Patients undergoing HBOT report improvements in pain relief, mobility, and overall quality of life, attributed to enhanced wound healing and resolution of associated symptoms.


  1. Kranke, P., Bennett, M., Roeckl-Wiedmann, I., & Debus, S. (2015). Hyperbaric oxygen therapy for chronic wounds.

  2. Sun, Z., & Chen, S. (2015). Antimicrobial Photodynamic Therapy and Hyperbaric Oxygen Therapy in the Treatment of Chronic Wounds: A Systematic Review. Photomedicine and Laser Surgery.

  3. Marx, R. E. (2004). Platelet-Rich Plasma (PRP): What is PRP and What is Not PRP? Implant Dentistry, 10(4), 225-228.

  4. Londahl, M., Katzman, P., Nilsson, A., Hammarlund, C., & Zang, X. (2011). Hyperbaric Oxygen Therapy Facilitates Healing of Chronic Foot Ulcers in Patients With Diabetes. Diabetes Care.

  5. Kelleher, S., & Norris, S. (2004). Hyperbaric oxygen therapy for chronic wounds. British Journal of Nursing.

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