The appearance of a wound (tissue continuity solution) causes the initiation of a set of mechanisms for its repair. In external wounds (of the skin), the completion of the procedure leads to the closure of the wound - repair of a skin defect. The phases included are: hemostasis, inflammation, proliferation phase and remodeling phase. Various local factors can affect this normal process, such as swelling, ischemia & necrosis, reduced oxygen levels. Also systemic factors, such as decreased blood supply, diabetes, inflammation, metabolic diseases, connective tissue diseases, smoking.

Suspension, at some stage, of the healing mechanism or delay in its progress leads to chronic trauma or chronic ulcer. This is more common in the lower extremities for a variety of reasons. In addition to financial costs and possible complications, their ineffective resolution significantly affects the social and psychological health of people with multiple end effects on quality of life.

In summary, Hyperbaric Oxygen Therapy has a strong indication in:


  1. Diabetic Foot, especially when the chronic trauma-ulcer is complicated by infection
  2. Metastatic disorders, when they lead to a chronic ulcer and especially when the underlying soft tissues and / or bones are threatened. If there is a need for surgery on irradiated tissues, even if small, HBO2 is indicated before and after
  3. Selected problem ulcers. When the aforementioned diabetes mellitus does not coexist, in an existing peripheral arterial disease, in ischemic trauma, HBO2 is required to ensure healing. The presence of rheumatic diseases - collagen disease, can lead to chronic trauma. In a venous ulcer, when it becomes chronic, it can offer significant help, as well as in a chronic trauma - an ulcer from surgery. In the presence of some of the above (diabetes, venous insufficiency, arterial disease, collagen disease, obstructive thrombangiitis [Buerger's disease]) the HBO2 should be sought early, before complications occur.
  4. When the chronic injury is very close to a bone and especially when it is involved (coexisting or even possible osteomyelitis) the HBO2 is required to fight the infection and definitive repair (in normal bone Oxygen is measured at about 40 mmHg, while in bone suffering from osteomyelitis Oxygen drops to 23 mmHg).


Vassilios N. Kalentzos MD, MPH