The Burden of Chronic Wounds
A wound is considered chronic when it fails to progress through the normal stages of healing within 30 days despite appropriate standard care. Chronic non-healing wounds affect an estimated 6.5 million patients in the United States and cost the healthcare system over 25 billion dollars annually. These wounds include venous leg ulcers, arterial insufficiency ulcers, pressure injuries, diabetic foot ulcers, and wounds resulting from radiation therapy or failed surgical healing.
For patients living with a chronic wound, the impact extends far beyond the physical. Non-healing wounds cause chronic pain, limit mobility, increase infection risk, require frequent medical visits, and can lead to depression and social isolation. When standard wound care fails, hyperbaric oxygen therapy offers a scientifically proven path to healing.
Why Wounds Fail to Heal
The common denominator in virtually all chronic wounds is inadequate oxygen delivery to the wound bed. Healing requires oxygen at every stage: immune cells need oxygen to fight infection, fibroblasts need oxygen to produce collagen, endothelial cells need oxygen to form new blood vessels, and epithelial cells need oxygen to close the wound surface. When tissue oxygen levels fall below the threshold needed for these processes, healing stalls regardless of how well the wound is managed externally.
The causes of inadequate wound oxygenation include peripheral vascular disease, diabetes, venous insufficiency, prior radiation, and edema. HBOT addresses the root cause by dramatically increasing tissue oxygen levels throughout the wound and surrounding tissue.
How HBOT Heals Chronic Wounds
HBOT delivers oxygen at 10 to 15 times normal atmospheric levels to the wound bed and periw ound tissue. This hyperoxygenation restores the oxygen-dependent healing processes that have stalled. It reactivates the immune response, enabling white blood cells to clear bacteria and biofilm from the wound. It stimulates fibroblast proliferation and collagen synthesis for tissue rebuilding. It drives angiogenesis, building new blood vessels that provide lasting oxygen supply. And it mobilizes stem cells from bone marrow to the wound site, where they differentiate into the cell types needed for repair.
The cumulative effect is a wound environment transformed from one that cannot heal to one that actively progresses toward closure. Many patients who have lived with open wounds for months or years see their wounds begin to close within weeks of starting HBOT.
Clinical Evidence
Non-healing wounds are among the most well-studied indications for HBOT. Large clinical studies and systematic reviews have demonstrated that HBOT significantly increases the rate of complete wound healing, reduces the risk of major amputation in diabetic foot ulcer patients, decreases wound-related hospital admissions, and improves quality of life. Medicare and most private insurers recognize HBOT for chronic non-healing wounds that have failed to respond to 30 days of standard wound care. Review the evidence on our HBOT research library.
Treatment Protocol
The typical HBOT protocol for chronic wounds involves 20 to 40 sessions at 2.0 to 2.4 ATA in a medical-grade chamber. Sessions last 90 minutes and are delivered daily, five days per week. Our physicians perform transcutaneous oxygen measurements to assess tissue oxygenation before and during treatment, ensuring the therapy is working as intended. Learn about what to expect at your first session and how to choose the right HBOT provider.
Treatment at National Hyperbaric
Chronic non-healing wounds are one of the most common conditions treated at our center. Dr. Allan Spiegel and Dr. Montana have treated thousands of wound patients and work closely with your wound care team to optimize outcomes. Contact us for a free consultation. Visit our cost and insurance page — wound care HBOT is widely covered by insurance. Explore all conditions we treat and our travel for treatment program. Check our FAQ.