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chronic wounds, HBOT, hyperbaric oxygen therapy, retrospective study, ulcer healing, wound, wound healing



  1. Lalieu, Rutger C. MD, PhD
  2. Bol Raap, Rene D. MD
  3. Smit, Casper MD, PhD
  4. Dubois, Emile F.L. MD, PhD
  5. van Hulst, Rob A. MD, PhD


OBJECTIVE: To analyze wound healing results of hyperbaric oxygen therapy (HBOT) for a variety of different wound types.


METHODS: This retrospective cohort study included all patients treated with HBOT and wound care at a single hyperbaric center between January 2017 and December 2020. The primary outcome was wound healing. Secondary outcome measures were quality of life (QoL), number of sessions, adverse effects, and treatment cost. Investigators also examined possible influencing factors, including age, sex, type and duration of wound, socioeconomic status, smoking status, and presence of peripheral vascular disease.


RESULTS: A total of 774 treatment series were recorded, with a median of 39 sessions per patient (interquartile range, 23-51 sessions). In total, 472 wounds (61.0%) healed, 177 (22.9%) partially healed, 41 (5.3%) deteriorated, and 39 (5.0%) minor and 45 (5.8%) major amputations were performed. Following HBOT, median wound surface area decreased from 4.4 cm2 to 0.2 cm2 (P < .01), and patient QoL improved from 60 to 75 on a 100-point scale (P < .01). The median cost of therapy was [Euro sign]9,188 (interquartile range, [Euro sign]5,947-[Euro sign]12,557). Frequently recorded adverse effects were fatigue, hyperoxic myopia, and middle ear barotrauma. Attending fewer than 30 sessions and having severe arterial disease were both associated with a negative outcome.


CONCLUSIONS: Adding HBOT to standard wound care increases wound healing and QoL in selected wounds. Patients with severe arterial disease should be screened for potential benefits. Most reported adverse effects are mild and transient.