Hyperbaric Oxygen Therapy (HBOT) for Wound Healing: What the Research Evidence Shows
- HBOT UK
- 16 hours ago
- 17 min read
Approximately 200,000 people in the UK are living with a chronic wound at any given time, costing the NHS an estimated £5.3 billion per year. For wounds that fail to respond to standard treatment - particularly ischemic diabetic foot ulcers - Hyperbaric oxygen therapy for wound healing research has become one of the most clinically studied areas in hyperbaric medicine.
Can HBOT help with wound healing? For selected problem wounds - particularly ischemic, infected diabetic foot ulcers - hyperbaric oxygen treatment is a formally approved indication by the Undersea and Hyperbaric Medical Society (UHMS) and is NHS-commissioned in the UK. Multiple clinical trials confirm improved short-term healing rates and reduced amputation risk in carefully selected patients. Long-term outcomes remain less conclusive, and patient selection is central to treatment decisions.
This article reviews the peer-reviewed evidence for HBOT wound healing, explains the biological mechanism, outlines research protocols, examines UHMS and NHS commissioning status, and addresses the most commonly asked questions from patients, caregivers, and clinicians in the UK.
Medical Disclaimer: This article is for general informational and educational purposes only. It does not constitute medical advice. Always consult a qualified GP or healthcare professional before considering HBOT, particularly if you have any pre-existing medical conditions, are pregnant, or are undergoing medical treatment.
Table of Contents
1. What Are Chronic Wounds?
Clinical Definition and Wound Types
A chronic wound is any wound that fails to progress through the normal healing stages - haemostasis, inflammation, proliferation, and remodelling - within 4 to 12 weeks. The most common types include diabetic foot ulcers (DFUs), venous leg ulcers, pressure ulcers, and ischemic wounds caused by peripheral arterial disease. Each type involves a breakdown in at least one essential phase of tissue repair.
Chronic wounds share three core pathological features: tissue hypoxia (insufficient oxygen at the wound bed), impaired angiogenesis (failure to generate new blood vessels), and prolonged inflammation that blocks the transition into active tissue repair. These features create a self-reinforcing cycle - the wound cannot repair because it lacks the oxygen-dependent resources to do so.
UK Patient Population Statistics
Diabetes UK reports that approximately 4.4 million people in the UK carry a diabetes diagnosis. Around 10% will develop a diabetic foot ulcer during their lifetime - a complication responsible for more than 135 lower-limb amputations per week in England alone. Beyond diabetic wounds, venous leg ulcers affect approximately 1 in 500 people and represent the most prevalent cause of chronic leg wounds in adults over 65.
Why Standard Care Often Falls Short
Standard wound care combines debridement, appropriate dressings, infection management, and offloading. Where vascular compromise and tissue hypoxia are central to the pathology, these approaches address downstream symptoms rather than the underlying oxygen deficit. Collagen synthesis, leukocyte-mediated bacterial killing, and new vessel formation are all oxygen-dependent processes - when local oxygen tension falls below the threshold needed to sustain them, wounds stall. This is precisely the therapeutic gap that HBOT wound healing research has attempted to address.
2. How Does Hyperbaric Oxygen Therapy Work?
The Physiological Mechanism of HBOT
Hyperbaric oxygen therapy (HBOT) involves breathing 100% oxygen inside a pressurised chamber at between 1.4 and 3.0 atmospheres absolute (ATA). At increased pressure, Henry's Law dictates that more oxygen dissolves directly into blood plasma. This plasma-dissolved oxygen can diffuse into hypoxic tissue far beyond the reach of compromised capillary networks - directly targeting the oxygen deficit that drives chronic wound stagnation.
A 2020 descriptive review published in PMC - Sunkari et al., Wound Repair and Regeneration - confirmed that this mechanism of plasma-dissolved oxygen delivery under pressure is the central physiological rationale for using HBOT in wound care.[1]
How HBOT Activates Wound Repair Pathways
The elevated tissue oxygen concentration from hyperbaric oxygen treatment activates several healing pathways simultaneously. Angiogenesis - the growth of new blood vessels - is stimulated through upregulation of vascular endothelial growth factor (VEGF). Fibroblast activity accelerates, producing the collagen scaffold needed for tissue reconstruction. Neutrophil (white blood cell) bacterial killing capacity also improves markedly under hyperoxic conditions.
A 2010 study published in PMC - Thom SR et al., American Journal of Physiology - found that HBOT induces a direct cytoprotective and angiogenic response in human microvascular endothelial cells, with the most pronounced effects observed following consecutive daily sessions.[8]
An additional mechanism - nitric oxide (NO) production - was explored in a 2007 PMC study (Boykin JV et al.), which documented a significant increase in local wound NO levels following successful HBOT wound healing treatment, suggesting NO-mediated vasodilation as a contributing pathway to wound closure.[12]
Reactive Oxygen Species: Therapeutic and Toxic Effects
HBOT paradoxically elevates reactive oxygen species (ROS) and reactive nitrogen species (RNS) - molecules that, at therapeutic doses, function as signalling agents driving healing cascades rather than causing damage. A 2021 cellular-level review published in PMC - Almeman AA et al. - confirmed that HBOT escalates ROS and RNS production, which underlie both the therapeutic and, at excessive doses, toxic effects.[13]
This dual action defines the therapeutic window and explains why correct ATA levels and session frequency matter clinically. Too little delivers insufficient oxygen-dependent signalling; too much risks oxidative tissue damage. This is why HBOT wound healing research consistently applies 2.0-2.4 ATA - not lower "wellness" pressures.
3. Hyperbaric Oxygen Therapy for Wound Healing: What the Research Shows
UHMS and NHS Recognition Status
The Undersea and Hyperbaric Medical Society (UHMS) formally recognises the enhancement of healing in selected problem wounds as an established indication for HBOT.
The UHMS Indications Manual (15th Edition) identifies ischemic, infected diabetic foot ulcers classified as Wagner Grade III or worse as the wound type with the strongest evidence for hyperbaric oxygen treatment.[10]
Wagner Grade III means deep ulceration extending to tendon, capsule, or bone, or wounds involving osteomyelitis (bone infection). For wounds at this grade or higher that have failed to respond to standard care, HBOT wound healing treatment is an evidence-supported clinical option.
NHS England directly commissions HBOT for specific wound healing conditions through its HBOT Service Specification (January 2025). This makes wound care one of only a small number of HBOT applications for which NHS-funded treatment is formally available.[11]
Key Finding - UHMS Wound Healing Approval HBOT wound healing is one of fewer than 15 conditions globally recognised by the UHMS as a formally approved indication. The strongest evidence applies to ischemic, infected diabetic foot ulcers (Wagner Grade III or worse) where standard wound care has failed. This places HBOT wound healing in a fundamentally different evidence category to investigational HBOT applications.
Positive Research Findings
A 2024 meta-analysis published in PMC - Myrthong OB et al. - evaluated adjuvant HBOT combined with standard wound care (SWC) versus SWC alone in patients with non-healing diabetic foot ulcers. The analysis found that adjuvant HBOT increases DFU healing rates by reducing wound size and surrounding inflammation, and by promoting granulation tissue regeneration. Complication rates were comparable between groups - supporting a favourable adjunct safety profile. The authors noted that larger randomised trials with longer follow-up are required to confirm the amputation prevention benefit.[4]
A 2023 study published in MDPI International Journal of Molecular Sciences - Coman OA et al. - measured biological markers in patients undergoing HBOT wound healing treatment for diabetic wounds. Plasma levels of the pro-inflammatory marker MMP9 (matrix metallopeptidase 9) decreased progressively during treatment. Growth factors, including PDGF (platelet-derived growth factor), TGF-β (transforming growth factor beta), and HIF-1α, increased during treatment and normalised following complete wound healing. The authors concluded that HBOT participates in activating healing, angiogenesis, and vascular tone regulation through these growth factor pathways. A key limitation was the relatively small cohort and the absence of a sham-treatment control group.[3]
A 2014 study published in PMC - Kim PJ et al., International Wound Journal - reviewed clinical effectiveness across 37 patients with complex wounds receiving HBOT. The study reported accelerated wound healing, with the most significant reduction in wound size occurring within the first 10 HBO sessions. The authors concluded that HBOT is an effective and safe treatment modality for complex wounds when applied at 2.0-2.4 ATA for 90 minutes per session.[14]
A 2026 systematic review published in PMC - Flores A et al., reviewing clinical evidence published between 2020 and 2025 - concluded that HBOT wound healing treatment significantly increases healing rates and reduces major and minor amputations in patients with chronic and ischemic wounds. Prospective data consistently confirmed that HBOT combined with standard wound care led to faster epithelialisation, enhanced granulation tissue formation, and lower minor amputation rates versus standard care alone.[9]
A randomised prospective controlled trial published in PMC - Duzgun AP et al., Journal of Foot and Ankle Surgery - compared HBOT plus standard care against standard care alone in chronic non-healing ulcers. Only 1 patient in the HBOT group required amputation compared to 5 in the control group. A positive correlation was confirmed between periwound transcutaneous oxygen pressure (TcPO2) values and wound healing outcomes - establishing TcPO2 as a reliable predictor of HBOT wound healing response.[7]
Mixed and Null Results
Not all studies have shown consistent benefit from HBOT wound healing treatment. The most significant source of neutral evidence is the 2015 Cochrane systematic review - Kranke P, Bennett MH, Martyn-St James M et al. - which included 12 trials and 577 participants. Pooled data from 5 trials with 205 participants showed an increase in ulcer healing rate at 6 weeks (Risk Ratio 2.35, 95% CI 1.19 to 4.62, p=0.01). However, this benefit was not maintained at longer-term follow-up at 1 year. The Cochrane reviewers called for adequately powered, large-scale randomised controlled trials before firm conclusions could be drawn - a call that remains substantially unmet.[2]
A 2020 randomised controlled trial published in PMC - Fedorko L, Bowen JM, Jones W et al. - found that evidence of HBOT effectiveness in DFU healing is variable. Some participants showed greater benefit versus sham treatment; others showed no statistically significant difference - particularly for amputation prevention outcomes. The authors attributed this heterogeneity to differences in wound classification, patient vascular status, and HBOT protocol variation across trial sites.[6]
A 2018 review published in PMC - Löndahl M et al. - further noted that the existing HBOT wound healing literature is largely restricted to diabetic wounds. Evidence for venous leg ulcers, pressure ulcers, and other chronic wound types remains insufficient to support routine clinical application beyond the DFU population - a gap that remains unaddressed in current research.[15]
Evidence Note - High Study Heterogeneity A consistent limitation across all HBOT wound healing systematic reviews is significant study heterogeneity: wound types, patient vascular status, ATA protocols, and session counts vary markedly across trials. This makes pooled effect sizes difficult to generalise. Patients with adequate tissue perfusion may experience fewer benefits than those with established vascular insufficiency and documented tissue hypoxia. TcPO2 pre-screening (see FAQ section) is the accepted method for identifying those most likely to respond.
Current and Ongoing Research Directions
Active investigation continues, with researchers focusing on three areas: refining TcPO2 measurement as a response predictor, optimising session protocols by wound type, and exploring HBOT in combination with other modalities. A 2024 systematic review and meta-analysis published in the Journal of Wound Care - Yang J et al., including 15 studies and 9 RCTs - found that HBOT wound healing treatment combined with negative pressure wound therapy (NPWT) produced significantly better outcomes than NPWT alone. Measured outcomes included improved wound healing rate (OR 6.77, 95% CI 3.53–12.98, p<0.0001) and lower bacterial positive rates across wound sites.[5]
A BMJ Open systematic review protocol - Vinkel J et al., 2020 - registered active investigation into the beneficial and harmful effects of adding HBOT to standard wound care specifically for diabetic foot ulcers, examining glycaemic control, atherosclerosis markers, and inflammatory markers alongside wound closure outcomes.[16]
4. Treatment Protocols Used in Research
The following figures describe protocols used in published research and clinical settings. They are not treatment advice or clinical recommendations for individual use.
Pressure Levels Studied in HBOT Wound Healing Research
Published HBOT wound healing research most consistently uses 2.0 to 2.4 ATA with 100% medical-grade oxygen. The UHMS Indications Manual identifies this pressure range as the basis for the approved wound healing evidence base. Individual clinical protocols are then refined based on wound type, vascular status, and patient response to initial sessions.[10]
Sub-2.0 ATA protocols (1.5–1.95 ATA) appear in some investigational literature, but the published evidence base for these lower pressures in wound healing is substantially thinner than for standard clinical-range protocols. This is a critical distinction for anyone considering HBOT wound healing outside a clinical environment.
Session Duration, Frequency, and Total Sessions
The following parameters are most commonly reported across peer-reviewed HBOT wound healing trials:
Pressure: 2.0-2.4 ATA
Oxygen concentration: 100% medical-grade oxygen
Session duration: 90 minutes at pressure
Frequency: 5 sessions per week (Monday to Friday)
Total sessions studied: 20-40 sessions per treatment course
Most common protocol: 30 sessions over 6 weeks
Adjunct approaches: HBOT applied alongside standard wound debridement, offloading, infection control, and - increasingly - negative pressure wound therapy (NPWT)
The randomised controlled trial by Duzgun AP et al. applied a 30-session protocol at 2.4 ATA with 90-minute sessions, 5 days per week, and confirmed significant improvements in both periwound TcPO2 measurements and wound closure rates compared to the control group.[7]
The 2014 clinical effectiveness study found that the most significant wound size reduction occurred within the first 10 consecutive HBO sessions - highlighting the importance of uninterrupted daily treatment during the early phase of an HBOT wound healing course.[14]
5. Safety Considerations and Contraindications
This article is for general informational and educational purposes only. It does not constitute medical advice. Hyperbaric oxygen chambers supplied by Hyperbaric Oxygen Treatment UK are wellness and professional equipment, not MHRA-regulated medical devices for the treatment of disease. Always consult a qualified GP or healthcare professional before considering HBOT, particularly if you have any pre-existing medical conditions, are pregnant, or are undergoing medical treatment.
Absolute Contraindications to HBOT
The following conditions are absolute contraindications to HBOT in all clinical guidelines. No HBOT wound healing programme should proceed without first screening for these:
Untreated pneumothorax (collapsed lung) pressure changes are immediately life-threatening without prior correction
Concurrent use of bleomycin or doxorubicin (certain chemotherapy agents), these drugs interact dangerously with hyperoxic conditions and can cause pulmonary toxicity
Uncontrolled seizure disorder, hyperoxia lowers seizure threshold; this must be managed medically before any HBOT commences
Relative Contraindications Requiring Clinical Assessment
These conditions require individual evaluation by a qualified clinician before HBOT wound healing treatment proceeds:
Severe COPD or emphysema - risk of CO2 retention under hyperoxic conditions
Untreated claustrophobia - chamber confinement may need desensitisation support
Active upper respiratory infections - risk of sinus and middle ear barotrauma during pressurisation
Pregnancy - used only where clinical benefit clearly outweighs risk; insufficient evidence to confirm safety
Implanted electronic devices (pacemakers, cochlear implants) - device-specific engineering and cardiology assessment required
Poorly controlled hyperglycaemia - diabetic patients undergoing HBOT wound healing courses should achieve glycaemic stability before treatment begins, as unstable blood glucose levels affect both wound healing and treatment safety
Reported Side Effects in Wound Healing Studies
Side effects reported across HBOT wound healing clinical trials are generally mild and reversible under appropriate clinical supervision:
Ear and sinus barotrauma - the most commonly reported adverse event; managed with pressure equalisation techniques prior to and during pressurisation
Temporary myopia (short-sightedness) - typically develops after multiple sessions and reverses after the course ends
Oxygen toxicity seizure - rare at therapeutic wound healing pressures; incidence estimated below 1 per 10,000 treatment sessions in supervised clinical settings
Transient fatigue and lightheadedness - reported in the immediate post-session period; resolves with rest
A 2020 descriptive review in PMC confirmed that adverse effects are generally mild and reversible when HBOT wound healing is delivered under appropriate clinical supervision at established ATA protocols.[1]
6. Who Is Currently Exploring HBOT for Wound Healing?
NHS-Commissioned Clinical Settings
In the UK, NHS-commissioned HBOT wound healing services are delivered at a small number of specialist hyperbaric medicine units. These centres accept referrals for wound types meeting NHS England's HBOT Service Specification criteria - with the focus on wounds where standard care has demonstrably failed and where TcPO2 perfusion studies support likely clinical responsiveness to hyperoxic treatment.
Vascular surgeons, podiatrists, and tissue viability nurses are the clinical professionals most commonly involved in assessing and referring patients for HBOT wound healing treatment. DDRC Healthcare in Plymouth is the UK's largest NHS-commissioned hyperbaric medicine facility and a key clinical reference point for HBOT in the British healthcare system.
European Clinical Context
Across Europe, the ECHM (European Committee for Hyperbaric Medicine) European Code of Good Practice for Hyperbaric Oxygen Therapy (2023) defines minimum operational and safety standards for HBOT wound healing facilities. This landmark document is available in full via PMC.
UK operators and European clinical centres delivering HBOT wound care are increasingly aligning with ECHM standards as the reference framework for consistent clinical delivery.
Private HBOT Provision
Beyond NHS settings, private HBOT clinics accept direct and self-referrals for adjunct wound healing treatment. Patients with DFUs who have exhausted NHS wound care pathways, or who do not meet the specific criteria for NHS commissioning, are among those exploring private hyperbaric oxygen treatment.
Research Settings
University-affiliated wound care research units continue investigating HBOT wound healing as an adjunct, particularly in defining TcPO2 pre-screening protocols to improve patient selection. Reducing heterogeneity in future trials through standardised wound classification, consistent ATA protocols, and longer follow-up remains a stated research priority across the current literature.[9]
7. Key Questions About HBOT and Wound Healing
Q. Is HBOT an approved treatment for wound healing?
A. Yes - HBOT wound healing is a UHMS-approved indication for the enhancement of healing in selected problem wounds. The UHMS specifically recognises ischemic, infected diabetic foot ulcers (Wagner Grade III or worse) as having the strongest clinical evidence. NHS England also directly commissions HBOT wound healing services through its national service specification, making this one of the few HBOT applications accessible through NHS pathways.[10]
Q. What does the research say about HBOT for wound healing?
A. The research shows consistent short-term healing benefits for diabetic foot ulcers - improved healing rates and reduced amputation risk in selected patients. However, the 2015 Cochrane systematic review found that short-term gains at 6 weeks were not confirmed at 1-year follow-up. More recent meta-analyses (2024 and 2026) report stronger positive effect sizes. High study heterogeneity remains the primary limitation preventing firm conclusions from applying universally.[2]
Q. What pressure levels are used in HBOT wound healing research?
A. Published HBOT wound healing research consistently uses 2.0 to 2.4 ATA with 100% oxygen and 90-minute sessions. This is the pressure range for which the UHMS-approved evidence base was generated. Home wellness chambers typically operate at 1.4–1.95 ATA, below clinical wound healing research protocols.[10]
Q. How many sessions have been studied for HBOT wound healing?
A. Trials most commonly study 20 to 40 sessions. A 30-session protocol over 6 weeks - 5 sessions per week at 2.4 ATA for 90 minutes - is the most frequently reported design. Individual response varies by wound severity, vascular status, and baseline TcPO2.[7]
Q. Is HBOT safe for people with chronic wounds?
A. HBOT wound healing is generally considered safe in carefully selected patients under appropriate clinical supervision. The most common side effect is ear and sinus barotrauma. Absolute contraindications - including untreated pneumothorax and specific chemotherapy drugs - must be fully screened before any treatment begins. Diabetic patients should have glycaemic control assessed before commencing a wound healing HBOT course.[1]
Q. Is HBOT available on the NHS for wound healing?
A. Yes - NHS England commissions HBOT wound healing services for eligible patients. Eligibility requires evidence that standard wound care has demonstrably failed and that perfusion studies support likely HBOT responsiveness. NHS access is through specialist hyperbaric medicine units rather than general hospital wound care services.[11]
Q. Can HBOT be used at home for wound healing?
A. Home hyperbaric chambers typically operate at 1.4–1.95 ATA, below the 2.0–2.4 ATA used in clinical HBOT wound healing trials. For serious wound conditions, including diabetic foot ulcers, home HBOT should only ever be explored as a complement to medically supervised wound care - never as a replacement for it. Any decision to explore HBOT at home alongside wound treatment must be made in consultation with a qualified GP or wound care specialist.
Q. What should I ask my doctor before trying HBOT for wound healing?
A. Ask your doctor to confirm your wound classification (Wagner Grade for DFUs), whether a TcPO2 perfusion measurement has been completed, whether your wound qualifies under NHS HBOT criteria, what the monitoring plan is during treatment, and whether any medications you are taking - particularly chemotherapy agents - interact with hyperoxic conditions.[10]
Q. Does HBOT help with all types of chronic wounds?
A. No. HBOT wound healing evidence is strongest for ischemic diabetic foot ulcers. Evidence for venous leg ulcers, pressure ulcers, and other chronic wound types is substantially weaker and does not currently support routine clinical application. The UHMS specifies "selected problem wounds" rather than all chronic wound types - reflecting the critical importance of wound classification and patient selection.[9]
Q. What is TcPO2, and why does it matter for HBOT wound healing?
A. TcPO2 - transcutaneous oxygen pressure - measures the oxygen tension in the skin surrounding a wound. A baseline TcPO2 below 40 mmHg indicates tissue hypoxia. A value rising above 200 mmHg during in-chamber testing at 2.0–2.4 ATA while breathing 100% oxygen predicts a favourable response to HBOT wound healing treatment. The Duzgun et al. randomised trial confirmed TcPO2 as a reliable wound healing response predictor - and its use is now standard in NHS-commissioned HBOT wound programmes for patient selection.[7]
Q. Is HBOT wound healing treatment the same as topical oxygen therapy?
A. No - these are distinct modalities. HBOT wound healing involves systemic pressurisation of the entire body inside a sealed chamber, raising plasma oxygen levels throughout the body. Topical oxygen therapy (TOT) delivers localised oxygen directly to the wound surface without systemic pressurisation. A 2023 systematic review published in PMC examined topical oxygen approaches and confirmed they operate through fundamentally different mechanisms than hyperbaric oxygen treatment - and that the UHMS wound healing indication specifically refers to systemic HBOT, not topical application.[17]
8. Summary of Current Evidence
HBOT wound healing occupies a distinct position among all HBOT applications. It is one of fewer than 15 conditions formally approved by the UHMS, and one of the very few for which NHS England directly commissions treatment. That institutional recognition reflects a genuine - if incomplete - evidence base rather than investigational optimism.
The strongest HBOT wound healing evidence applies to ischemic, infected diabetic foot ulcers classified as Wagner Grade III or worse. Multiple peer-reviewed trials and meta-analyses support short-term improvements in healing rate, granulation tissue formation, and reduction in minor amputation rates when HBOT is added to standard wound care.[9][4]
The 2015 Cochrane systematic review - the most methodologically rigorous summary of HBOT wound healing evidence available - found that short-term benefits at 6 weeks were not maintained at 1-year follow-up. Evidence for wound types beyond diabetic foot ulcers remains insufficient for routine clinical recommendations.[2]
Patient selection using TcPO2 perfusion measurement, rigorous wound classification, and screening for absolute contraindications are prerequisites for safe and effective use. Research protocols for HBOT wound healing most consistently use 2.0-2.4 ATA, 90-minute sessions, 5 days per week, for 20 to 40 sessions total. Until larger adequately powered RCTs with long-term follow-up are completed, the evidence base supports HBOT as a clinically validated adjunct therapy for selected problem wounds - not as a standalone cure or universally applicable wound treatment.[7]
Medical Disclaimer: This article is for general informational and educational purposes only. It does not constitute medical advice. Hyperbaric oxygen chambers supplied by Hyperbaric Oxygen Treatment UK are wellness and professional equipment, not MHRA-regulated medical devices for the treatment of disease. Always consult a qualified GP or healthcare professional before considering HBOT, particularly if you have any pre-existing medical conditions, are pregnant, or are undergoing medical treatment.
This research review is published by Hyperbaric Oxygen Treatment UK, a specialist hyperbaric chamber supplier and installer based in Cleveleys, Lancashire, UK, with 120+ chamber installations across the UK, Europe, and internationally. Member of the International Board of Undersea Medicine (IBUM) and the International Hyperbarics Association (IHA). Information about available HBOT equipment for clinical and home environments can be found at hyperbaricoxygentreatment.uk.
9. References & Medical Sources
Sunkari VG, Lind F, Botusan IR, et al. "Hyperbaric Oxygen Therapy: Descriptive Review of the Technology and Current Application in Chronic Wounds." Wound Repair and Regeneration, 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7544320/
Kranke P, Bennett MH, Martyn-St James M, et al. "Hyperbaric oxygen therapy for chronic wounds." Cochrane Database of Systematic Reviews, 2015. https://pmc.ncbi.nlm.nih.gov/articles/PMC7055586/
Coman OA, Coman L, et al. "Hyperbaric Oxygen Therapy Reduces Oxidative Stress and Inflammation, and Increases Growth Factors Favouring the Healing Process of Diabetic Wounds." MDPI International Journal of Molecular Sciences, 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC10139175/
Myrthong OB, et al. "Hyperbaric Oxygen Therapy Combined With Standard Wound Care for Diabetic Foot Ulcers: A Meta-Analysis." PMC, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11689789/
Yang J, et al. "Adjunctive Hyperbaric Oxygen Therapy and Negative Pressure Wound Therapy for Hard-to-Heal Wounds: A Systematic Review and Meta-Analysis." Journal of Wound Care, 2024. https://www.magonlinelibrary.com/doi/10.12968/jowc.2022.0213
Fedorko L, Bowen JM, Jones W, et al. "Hyperbaric Oxygen Therapy Does Not Reduce Indications for Amputation in Patients With Diabetes With Nonhealing Ulcers of the Lower Limb: A Prospective, Double-Blind, Randomized Controlled Clinical Trial." PMC, 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7526398/
Duzgun AP, Satir HZ, Ozozan O, et al. "Evaluation of the Efficacy of Hyperbaric Oxygen Therapy in the Management of Chronic Nonhealing Ulcer and Role of Periwound Transcutaneous Oximetry as a Predictor of Wound Healing Response: A Randomized Prospective Controlled Trial." PMC, 2008. https://pmc.ncbi.nlm.nih.gov/articles/PMC3275977/
Thom SR, et al. "Hyperbaric Oxygen Induces a Cytoprotective and Angiogenic Response in Human Microvascular Endothelial Cells." PMC / American Journal of Physiology, 2010. https://pmc.ncbi.nlm.nih.gov/articles/PMC3082642/
Flores A, et al. "Hyperbaric Oxygen Therapy in Modern Surgical Practice." PMC, 2026. https://pmc.ncbi.nlm.nih.gov/articles/PMC12924891/
Undersea and Hyperbaric Medical Society. "HBO Indications - UHMS Indications Manual, 15th Edition." UHMS, 2020. https://www.uhms.org/resources/featured-resources/hbo-indications.html
NHS England. "Hyperbaric Oxygen Therapy Services (All Ages) - Service Specification." January 2025. https://www.england.nhs.uk/wp-content/uploads/2018/11/Hyperbaric-oxygen-therapy-services-all-ages-Service-specification-January-2025.pdf
Boykin JV Jr, Baylis C. "Hyperbaric Oxygen Therapy Mediates Increased Nitric Oxide Production Associated With Wound Healing: A Preliminary Study." PMC / Advances in Skin & Wound Care, 2007. https://pmc.ncbi.nlm.nih.gov/articles/PMC2756815/
Almeman AA, et al. "Hyperbaric Oxygen Influences Chronic Wound Healing - A Cellular Level Review." PMC, 2021. https://pmc.ncbi.nlm.nih.gov/articles/PMC8884396/
Kim PJ, et al. "Clinical Effectiveness of Hyperbaric Oxygen Therapy in Complex Wounds." International Wound Journal / PMC, 2014. https://pmc.ncbi.nlm.nih.gov/articles/PMC4566868/
Löndahl M, et al. "Hyperbaric Oxygen Therapy and Intermittent Ischaemia in the Treatment of Chronic Wounds." PMC, 2018. https://pmc.ncbi.nlm.nih.gov/articles/PMC7949927/
Vinkel J, et al. "Effects of Adding Adjunctive Hyperbaric Oxygen Therapy to Standard Wound Care for Diabetic Foot Ulcers - Systematic Review Protocol." BMJ Open, 2020. https://bmjopen.bmj.com/content/10/6/e031708
Systematic review of topical oxygen therapy effects on wounds. PMC, 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC11737428/
European Committee for Hyperbaric Medicine. "European Code of Good Practice for Hyperbaric Oxygen Therapy." PMC / ECHM, 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC10911829/
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