Normal wound healing proceeds through a sequence of steps involving the control of contamination and infection, control of inflammation, regeneration of the connective tissue matrix, angiogenesis, and resurfacing. These steps are critically dependent upon adequate oxygen availability and perfusion. When these processes are interrupted Hyperbaric Oxygen Therapy (HBOT) is highly important to assist in healing devitalized tissue, controlling infections, and assisting in collagen reproduction and angiogenesis (regenerating blood supply). This is usually an adjunctive therapy to enhance antibiotics and possible surgical interventions.
Optimizing wound perfusion and providing supplemental O2 in the peri-operative period reduces the incidence of postoperative infections. Correction of wound pO2 may, by itself, trigger some healing responses. The goal of HBOT is to create a greater oxygen concentration in hypoxic tissue (lack of oxygen) by breathing larger doses of oxygen at greater than normal
atmospheric pressure increasing oxygen concentrations (partial pressures in blood plasmas) upwards of 1000%. (The greater the pressure, the greater the O2 concentration.)
Diabetic Wounds (ICD 10 ulcer L89., diabetic E11._ please define type, manifestation, and stated control/uncontrolled)
These are generally the most common type of wound treated with HBOT but do require workup to include APX and 30 days of conservative care with no significant improvement. Treatment is generally prescribed as 30 treatments.
Grafts and Surgical Flaps (compromised skin grafts ICD 10 T86.82_ excludes artificial grafts)
Grafts that are failing or need extra care in the healing process (such as MOHS procedures) are great candidates for HBOT. The number of treatments prescribed is 20.
Chronic Refractory Osteomyelitis (ICD 10 M86.61 non-specific chronic osteomyelitis) is also a strong indicator for HBOT increasing perfusion to surrounding tissues and effective delivery of O2 to low oxygen, dense bone and marrow. Prescribed as 45 treatments due to intractability.
Non-Healing Surgical Wounds (ICD 10 T81.89XA) are also treatable with HBOT. Any wounds that have not undergone the normal processes of healing or the healing progress is prolonged and not progressing can fall under this category
These indications can also be used postoperatively if leading to amputation of the above treatments This is not a definitive list of indications. If you have questions about a specific diagnosis, please contact us
All referrals require PHYSICIAN RX to CONSULT FOR HBO EVALUATION