What wounds qualify for hyperbaric oxygen therapy?

There are 14 approved indications, set by the Undersea and Hyperbaric Medical Society. For wound healing, the named one is Wagner grade 3 diabetic wounds that have not responded to at least 30 days of conventional therapy.

There is a defined list, which is more than can be said for most wound treatments, and it’s set by a professional body, not by individual clinics.

The Undersea and Hyperbaric Medical Society is the international body that sets standards for the use of hyperbaric medicine. There are currently 14 approved indications, with many more unapproved conditions where the therapy may be useful.

The approved conditions are decompression sickness, acute arterial gas emboli, necrotizing fasciitis, gas gangrene, refractory osteomyelitis, acute blood loss anemia, failed skin grafts, chronic radiation injury, carbon monoxide poisoning, acute thermal injury, compartment syndromes, compression injury, cranial abscess, arterial insufficiency, and acute sensory hearing loss.

For wound healing specifically, one indication is named precisely: Wagner grade 3 diabetic wounds refractory to at least 30 days of conventional therapy. The Wagner scale grades how severe diabetic foot wounds are, and grade 3 means abscess, osteomyelitis, or tendonitis.

“Refractory to at least 30 days of conventional therapy” is the part that catches people out. This is not a first treatment. It describes a wound that has already been treated the usual way for a month without responding.

It’s just as clear what doesn’t qualify. Autism, stroke and attention deficit hyperactivity disorder are among numerous off-label uses that have not been proven to respond to hyperbaric oxygen therapy.

In practice, depending on the type of wound, your provider may recommend hyperbaric oxygen therapy, and it can help some wounds heal faster. Some wounds, and depending on the type.

What to watch for

One wound-healing indication is named specifically: Wagner grade 3 diabetic wounds refractory to at least 30 days of conventional therapy. A wound that has not yet had a month of conventional treatment is not in that category.

Autism, stroke and attention deficit hyperactivity disorder are among off-label uses that have not been proven to respond to the therapy.

The therapy can help some wounds heal faster, and whether it is recommended depends on the type of wound.

Whether a particular wound qualifies is a clinical judgment, not something this page can settle.

Wound Wizard is general education and can’t assess your wound. Your own clinician is the right person to ask.

What we look at

  • Determining why the wound is not healing
  • Grading a diabetic foot wound
  • Deciding whether the wound meets an approved indication
  • Explaining what a course would involve

Sources

  1. Hyperbaric Therapy for Wound Healing — StatPearls, National Library of Medicine https://www.ncbi.nlm.nih.gov/books/NBK459172/
  2. Wound care centers — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000739.htm