Complicated and chronic wounds never have a simple reason for their slow healing. Whether the wound from an injury, appeared gradually, or came about surgically, if it’s not healing, there’s usually a mixed bag of problems.
What is HBO wound care?
This is the integration of hyperbaric oxygen therapy (HBOT) into a wound healing plan of care. This can also involve dressing changes, debridement, improving nutrition, and more. Therapy for wound healing generally has several components, since healing requires several systems of the body to work together.
How does HBOT improve tissue wound healing?
Several factors can cause a wound to stall in its healing. Some of the main reasons are:1
- Hypoxia—the tissues are not getting enough oxygen
- Inadequate collagen and tissue synthesis—tissue isn’t being made fast enough to keep up with the body’s demand.
- Poor immune response—the body isn’t fighting infection as effectively as it should.
- Increased inflammation—prolong swelling keeps the body from healing appropriately.
Oxygen plays a large role in all of these, which is why hyperbaric oxygen therapy (HBOT) is such an effective therapy for certain wounds.
Oxygen is a key component in energy production at a cellular level. When the body has increased demand for a certain process, more oxygen is needed. When the body has a wound, it has an increased need to divert energy to building up new tissue.
But don’t we get oxygen through breathing? This is absolutely true. Normally we breathe it in and the oxygen travels to the cells via our blood vessels.
But in a non-healing wound, there may be a factor hindering the oxygen from getting to your wound. For example, exposed bone or tendon generally does not have blood vessels covering the surface. Because of this, it’s very hard for oxygen to get to the affected area like it normally would.
This creates a vicious cycle. The body needs to cover up the bone, tendon, or damaged skin with capillary-rich tissue. But can’t do so until it has more oxygen. The way you get more oxygen is through working blood vessels around the damaged area.
This is where HBOT steps in. Instead of having to rely on poor blood vessels taking oxygen to your wound site, you’ll get increased oxygen through breathing and having it pushed into your tissues from the outside.2
Inadequate collagen and tissue synthesis
Listen to those hunches if you feel like a wound is taking a lot longer than it should to heal. Wounds take time to heal but if you were seeing no progression in two week, then you may have a complex, chronic wound. Your body is not producing the tissue and collagen it should at the rate it needs.
To build up new tissue, the body needs several materials:3
- Micronutrients—vitamins and minerals
- Macronutrients—protein, carbohydrates, and fats
These get to the cells through the circulatory system. So if blood vessels are out of commission, your wound is not going to get the deliveries of construction materials it needs.
Many common problems causing circulation damage turn into devastating roadblocks for wound healing:
- Venous stasis. This is where your veins don’t pump fluid back up your legs as efficiently as they used to. This results in fluid pooling in your legs in between the cells. This widens the spaces between the cells, making it harder for the circulation to get the nutrients it needs to the cells.
- Radiation damage. Radiation damage, especially from cancer treatment, targets the fastest-growing cells in your body. Some very fast-growing cells include the cells that make up capillaries.
- Diabetes. Diabetes, especially long-term and uncontrolled, damages the integrity of tissues and blood vessels. They become more prone to breaking down and have a harder time repairing themselves.
In short, HBOT helps facilitate building new blood vessels. These in turn help build new tissue to heal a wound.
Poor immune response
HBO therapy has a direct bactericidal effect—it helps kill bacteria.4 In slow healing wounds, infection is a huge risk to, if not the cause of, a slow healing process. HBO therapy has particularly good results with deep infections like
- Osteomyelitis (infection in the bone). Antibiotics often have a difficult time penetrating bone. Bone infections can use all the help they can get from HBOT to fighting such a risky infection.
- Chronic soft tissue infections (flesh-eating and chronic infections). These infections are often fast-moving and recurrent, and usually need a combination of therapies to treat.
- Intracranial abscesses (pockets of infection in the brain). When pus and the infected matter is under the skull, it’s not so simple to cut out.
HBOT helps reduce infection, which is especially helpful with complicated cases.
Inflamed tissues are correlated with hypoxia (low levels of oxygen). Inflammation can be caused by hypoxia, and hypoxia can lead to inflammation.5 Tissues that are experiencing hypoxia typically do so because the blood vessels surrounding the tissue aren’t efficiently supplying oxygen.
Inflammation also increases the space between the cells. It’s like lengthening all the roads to a construction site. If there is chronic inflammation around a wound, it’s hard for the necessary building equipment (like oxygen and nutrients) to get to the construction site (the wound).
HBOT helps reduce inflammation, which helps cells get the nutrients they need from blood vessels.
Decreased vascular permeability and extracellular space
In plain English, this means swelling makes cells less tightly packed together, and the blood vessels leakier. When the cells are not as close together, blood circulation has to travel further, and it has a harder time getting to peripheral cells.6 Venous insufficiency and diabetes are common examples.
These cause swelling, but not necessarily from inflammation. It puts your skin at the same risk by putting more distance between your cells and the blood vessels. By reducing this, HBOT helps your cells get what they need from your circulation.
You may qualify for hyperbaric oxygen therapy for your non-healing wounds
If your wound is not improving with traditional therapies, talk to your doctor about HBOT. Many insurances cover HBOT for specific serious wounds, so feel free to discuss your case with one of our specialists to see if you qualify.
Looking for hyperbaric wound care near you in the Georgia or North Carolina area? Make an appointment through our contact form here, or give us a call at 770-422-0517.
[While the above is meant to inform, it’s not meant to replace the advice of a doctor that’s been able to assess your case. Please consult a physician if you have medical concerns.]