A non healing wound treated with hyperbaric oxygen therapy

Problem wounds represent a significant and growing challenge to our healthcare system. The incidence and prevalence of these wounds are increasing in the population resulting in growing utilization of healthcare resources. These problem wounds may arise from excessive pressure, trauma, venous insufficiency, diabetes mellitus, vascular disease, or prolonged immobilization leading to its difficult management with significant increases in cost, disability, and liability. Healing of such wounds is a dynamic pathway requiring the presence of oxygen for optimal restoration of tissue integrity and function needs good building blocks for repair and a good transport system to get the building blocks to the site of action. Hyperbaric oxygen therapy (HBOT) is used as a therapeutic modality which leads to an increase in tissue oxygen pressures at the wound site and hence allowing the reversal of a hypoxic state by increasing the oxygen diffusion within the plasma, consequently promoting angiogenesis, encouraging fibroblastic activity and supporting the tissues to resist against bacteria. It is used as an adjunctive treatment to enhance best-practice wound care and employing HBOT in a directed and appropriate way can significantly enhance wound healing efforts. We review a case of 17 year old girl with Grade I pressure ulcer over her right heel since 6 years and role of hyperbaric oxygen therapy as an adjunctive for its management.