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Exploring Hyperbaric Oxygen Therapy (HBOT) and its Role in Wound Healing by Dr Surya Teja

Exploring Hyperbaric Oxygen Therapy (HBOT) and its Role in Wound Healing by Dr Surya Teja

Hyperbaric Oxygen Therapy involves exposing patients to 100%oxygen at pressures greater than atmospheric pressure. This high-pressureenvironment allows the lungs to absorb more oxygen, which is then dissolvedinto the bloodstream and delivered to tissues throughout the body. HBOTsessions typically last between 60 to 90 minutes and may be repeated overseveral weeks depending on the condition being treated.(1)

The number ofindications for which HBOT has been used has been steadily increasing so muchso that 132 are documented past and present indications for which it has beenused. Some of these indications include diabetic foot ulcers, crush injury,compartment syndrome, decompression illness, and severe anemia. Undersea andHyperbaric Medicine Society (UHMS) has recognized various indications as“Approved” indications. These indications had also been approved by the BritishHyperbaric Association. (1)

Apart from theapproved indications, several areas are being explored to determine if HBOTmight be of some clinical benefit. These areas include senility, stroke,multiple sclerosis, sports injuries, high altitude illness, myocardialinfarction, brain injuries, migraine, glaucoma, head injuries, management ofchronic fatigue in HIV-positive patients, and enhancement of survival in freeflaps. (1)

HBOT in sports:

Hyperbaric oxygen therapy has become popular among injuredathletes because of its hypothetical benefits on accelerated recovery,especially among professional athletes or those with substantial financialresources.(2) Under the effect of HBOT,the transition from an inflammatory state to a proliferative state isaccelerated. This accelerated transition has been evidenced by the increase inthe number of anti-inflammatory macrophages compared to pro-inflammatory macrophages(2)

HBOT in angiogenesis:

By amultifactorial process, HBOT improves angiogenesis. Collagen is the basicmatrix for angiogenesis because both fibroblast development and collagensynthesis are dependent on oxygen. Furthermore, it is probable that HBOTactivates growth factors, especially vascular endothelial growth factor (VEGF),which in turn influences angiogenesis and additional mediators of the woundhealing process. Hyperbaricoxygen also has been shown to have direct and indirect antimicrobial activity. (3)

HyperbaricOxygen Therapy (HBOT) is a potentially effective therapeutic method to promotewound healing. HBOT optimizes the body's natural healing processes bystimulating angiogenesis, decreasing inflammation, enhancing oxygen flow totissues, and exerting antimicrobial effects. Clinical research has shown thatHBOT is effective in accelerating the healing of a variety of lesions, such asradiation-induced tissue damage and diabetic foot ulcers. HBOT might become auseful supplemental treatment for people with chronic or non-healing wounds.

References: 

1.              Bhutani S, Vishwanath G.Hyperbaric oxygen and wound healing. Indian J Plast Surg. 2012May;45(02):316–24.

2.              Moghadam N, HiedaM, Ramey L, Levine BD, Guilliod R. Hyperbaric Oxygen Therapy in SportsMusculoskeletal Injuries. Medicine & Science in Sports & Exercise. 2020Jun;52(6):1420.

3.              De Wolde SD,Hulskes RH, Weenink RP, Hollmann MW, Van Hulst RA. The Effects of HyperbaricOxygenation on Oxidative Stress, Inflammation and Angiogenesis. Biomolecules.2021 Aug;11(8):1210.