Hyperbaric Oxygen Therapy Applications in Wound Healing
Summary
Hyperbaric oxygen therapy (HBOT) delivers 100 per cent oxygen at pressures above atmospheric levels, typically between 2 and 3 atmospheres absolute. Elevated pressure increases dissolved oxygen in plasma and tissues, overcoming local hypoxia and promoting cellular processes essential for wound repair. HBOT enhances angiogenesis by stimulating endothelial cell proliferation and upregulating growth factors such as vascular endothelial growth factor and platelet-derived growth factor. It modulates inflammation by reducing pro-inflammatory cytokines and oxidative stress biomarkers, while supporting fibroblast activity, collagen deposition and extracellular matrix remodelling. Clinically, HBOT has been applied to chronic diabetic foot ulcers, radiation-induced tissue damage, necrotising soft tissue infections and refractory grafts. Treatment protocols vary according to wound aetiology, with common regimens involving daily 60–90-minute sessions over several weeks. Emerging evidence suggests synergistic benefits when HBOT is combined with advanced dressings, negative-pressure wound therapy or cellular therapies. Despite increasing uptake, optimisation of pressure, duration and patient selection remains under investigation to maximise efficacy and safety.
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Hyperbaric Oxygen Therapy Applications in Wound Healing publication trend
The graph below shows the total number of articles in hyperbaric oxygen therapy applications in wound healing across all publications each year (not limited to Nature Index journals).
Technical terms
Hyperoxia: Elevated partial pressure of oxygen in tissues above normal physiological levels.
Angiogenesis: Formation of new blood vessels from pre-existing vasculature, crucial for supplying oxygen and nutrients to healing tissue.
Oxidative stress: Imbalance between reactive oxygen species production and antioxidant defences, leading to cellular damage.
Growth factors: Signalling proteins such as platelet-derived growth factor and transforming growth factor-β that regulate cell proliferation and matrix synthesis.
Hypoxia-inducible factor (HIF-1α): Transcription factor stabilised under low oxygen conditions, controlling genes that mediate angiogenesis and metabolism.
Cytokines: Small proteins, including tumour necrosis factor-alpha and interleukins, that modulate inflammation and immune responses.
Matrix metalloproteinases (MMPs): Enzymes that degrade extracellular matrix components, involved in tissue remodelling and wound resolution.
References
- Hyperbaric Oxygen Therapy Reduces Oxidative Stress and Inflammation, and Increases Growth Factors Favouring the Healing Process of Diabetic Wounds. International Journal of Molecular Sciences (2023).
- A General Overview on the Hyperbaric Oxygen Therapy: Applications, Mechanisms and Translational Opportunities. Medicina (2021).
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