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HBOT for Wound Care

Hyperbaric Oxygen Therapy Healing Under Pressure

A Hyperbaric Oxygen Multiplace Chamber


Healing Under Pressure


A Testimony of Hyperbaric Oxygen Therapy By Kathy Summers



HBOT for Angiogenesis

Last summer I broke the neck of my femur clear through (technically a hip fracture) when my horse launched me like a rubber band into the dirt. But that wasn’t the scary part. The fracture was nothing compared to how I felt when the emergency room staff said the words “hip replacement. ”My orthopedic surgeon decided to try setting the bone first, but he gave me slim odds for healing. He said I had almost certainly severed the capillaries that feed the head of the femur, and with no backup blood flow it would begin to die (called avascular necrosis or AVN). When I asked what I could do to prevent this, he said, “Just one thing: hyperbaric oxygen. ”I immediately signed up for 20 daily treatments at Scottsdale Healthcare Osborn in Scottsdale, Arizona.

How HBOT Benefits Maximum Medical Improvement

To benefit from this peculiar therapy all you do is breathe. The key is to breathe 100 percent pure oxygen through a mask or hood for one to two hours a day while sitting in a pressurized chamber. Hyperbaric oxygen therapy (HBOT) works according to a simple law of physics that says oxygen under pressure dissolves into the body’s fluids—including blood plasma, lymph, and cerebral spinal fluid—where it can speed healing.

Hyperbaric Chambers

Hyperbaric hospitals and clinics typically operate monoplace chambers that resemble glass coffins, but I shared dives (as they sometimes call the treatments) in a 12-person multiplace chamber that looks like a submarine. Other than some ear pressure aI healed completely with no complications and no need for a hip replacement. I was lucky because few orthopedic surgeons refer hip fracture patients for HBOTnd temperature changes similar to landing in an airplane, the experience is comfortable with no serious side effects.

In cases like mine, HBOT can help the body develop new blood vessels [angiogenesis], remodel bone, and reduce secondary swelling and bruising if it is provided soon enough after the injury or surgery. “When you reduce the inflammatory edema you get rid of the bruising a lot quicker, so you get better circulation to the injured areas,” says Dennis Weiland, MD, Scottsdale Healthcare’s director of hyperbaric medicine. In fact, not only did my deep bruises disappear quickly, I healed completely with no complications and no need for a hip replacement. I was lucky because few orthopedic surgeons refer hip fracture patients for HBOT. Doctors are more likely to prescribe the treatments for wounds that won’t heal.

Angiogenesis: The Key to Harch HBOT Healing of a Wound


Angiogenesis: The Key to Hyperbaric Oxygen HBOT Therapy

by Paul Harch, M.D.


Researchers continue to document an increasing number of acute and chronic drug effects of Hyperbaric Oxygen Therapy (HBOT).  Acutely, HBOT corrects hypoxia [oxygen deprived], reduces edema, augments WBC-mediated bacterial killing, inhibits an aerobic bacteria, and profoundly decreases reperfusion injury. In chronic wounding HBOT induced effects are trophic: fibroblast proliferation, collagen deposition, epithelialization, and angiogenesis. The latter process is the basis for HBOT generated wound healing and the topic of this HBO on the Avenue.  

ANGIOGENESIS, or new blood vessel growth, is critical to wound healing. In normal wound management with minimal tissue destruction angiogenesis occurs without problems at the wound edge where a steep oxygen gradient exists. The stimulus for angiogenesis is hypoxia at the wound edge that causes various growth factors to be released from wound macrophages. This same hypoxia is responsible for retinopathy in newborns and preemies after abrupt withdrawal of supplemental oxygen and in newborn animals subjected to hypoxic environments. Hypoxia is similarly present in chronic or non-healing wounds, but the difference is that the oxygen gradient is very shallow.  While no one has defined the exact slope of the shallow gradient, i.e. the distance over which oxygen reduction occurs in a non-healing wound, it is the usual underlying pathophysiology in most non-healing chronic wounds. Besides large vessel revascularization, to date only one therapy has been shown to consistently correct the shallow oxygen gradient and induce angiogenesis: HYPERBARIC OXYGEN THERAPY. 

The best model so far developed to study shallow perfusion gradient wounds and the one in which HBOT's angiogenesis effects have been unequivocally demonstrated is irradiated tissue. External beam radiation causes a well-defined stereotypic delayed thrombosis of small blood vessels that is maximal at the center of the beam and tapers at the edges. Marx (1) exploited this wound in animals and humans to show that HBOT caused a progressive angiogenesis at the wound margin by generating a steep oxygen gradient with intermittent repetitive HBOT. Over a course of about 30 treatments new vessel growth infiltrated the wound and achieved pO₂'s of about 85% of control tissue. Similar HBOT angiogenesis has been achieved in animals by Manson (2), Rohr (3), Meltzer (4), Nemiroff (5), Zhao (6), and others. This is the underlying basis of all HBOT in chronic wounding and accounts for the ability to heal diabetic foot wounds, arterial insufficiency ulcers, traumatic ischemic wounds, bums, and other devascularized wounds, providing major arterial supply is not severely decreased. On reverse side is an example of HBOT's angiogenesis capability.