introduction and phases
of wound healing
personal factors that
affect wound healing - nutrition, fluids, smoking
personal factors that
affect wound healing - diabetes, movement, steroids,
alcohol, stress, sun exposure, other factors
surgical and post operative
factors that affect wound healing
- bromelain, vitamin K cream
scar formation and treatment
hyperbaric oxygen therapy
Hyperbaric Oxygen Therapy
(HBO Therapy, HBOT, or Hyper-oxygenation)
What is HBOT?
HBO Therapy is used to treat a variety of conditions,
and can be especially useful after surgery to treat
infections, burns, severe swelling, blood loss, chronic
non-healing wounds, and ischemia (inadequate blood and
therefore, oxygen flow) to wounds, flaps, and skin grafts.
HBOT is most commonly known to treat decompression sickness,
known as "the bends", in scuba divers.
How It Works
Normally the air we breathe is only about 20% oxygen
and 80% nitrogen. With hyperbaric (pressurized) oxygen
therapy, the air pressure is increased by 2 to 3 times
the normal pressure, and the patient breathes and is
surrounded by 100 percent pure oxygen. The increased
pressure combined with maximum oxygen content dissolves
oxygen and forces it into the tissues, resulting in
10 to 20 times the normal blood oxygen concentration.
Increased oxygen then helps new healthy cells to grow,
and helps your body's white blood cells to fight infection.
The usual treatment guidelines for wound healing prescribe
90 minutes a day at twice normal atmospheric pressure,
and usually recur five days a week for several weeks.
HBO Therapy can be performed either in a chamber that
holds only one person or up to a dozen people at a time.
Multi-place chambers (with room for several or more
people) are considered safer because you can be treated
for emergencies while still in the chamber without releasing
the pressure. Either way, static electricity combined
with oxygen in the chamber makes it highly flammable
(remember the Hindenburg?), so you must enter completely
clean of hairspray, lotion, makeup, perfume, shoes,
etc. and wearing only 100% cotton or anti-static fabric.
Of course, other flammable items like lighters, matches,
and electrical equipment are prohibited.
You should not have HBO Therapy if you are pregnant,
have seizure disorders, malignant tumors, high fevers,
upper respiratory infection (flu/cold/cough/ear or sinus
infection), emphysema or COPD (chronic obstructive pulmonary
disease), history of pneumothorax (collapsed lung),
optic neuritis (inflammation of the nerve to the eye),
or with some medications. Insulin diabetic patients
must bring their insulin into the chamber. There have
been some reports of worsening of cataracts and other
Risk and Complications
The most common problems with the treatments are caused
by the increased pressure. The number one difficulty
is equalizing the ears (like when you go diving or travel
to high altitude). Before you are treated, you will
learn several methods to "clear" your ears.
You could also develop abdominal problems from gas in
the intestines, tooth pain, ear or sinus pain and/or
bleeding, dizziness, and hearing loss, or a collapsed
lung from the pressure. It is possible to get too much
of a good thing, in this case resulting in oxygen toxicity.
Symptoms of oxygen toxicity are nausea and vomiting,
seizures, sweating, ringing in the ears, hallucinations,
dizziness, decreased consciousness and even hiccups.
Dramatic results have been documented with the use of
hyper-oxygenation, so if it's so wonderful, why isn't
everyone using it? The biggest reasons are that the
cost can be high (up to $500 per treatment); the majority
of doctors do not learn about HBOT in medical school,
or even in their residency so it's not yet engrained
in their thinking; and it is not widely available except
in larger metropolitan areas (although it is becoming
more and more accessible).