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During the proliferative phase, approximately 2 days into wound healing, macrophages continue to express growth factors, many of which stimulate angiogenesis and formation of granulation tissue comprising of endothelial cells, fibroblasts, and inflammatory cells.

Patients with problem non-healing wounds attending the DDRC Healthcare facility ( in Plymouth, UK, are treated using the protocol outlined in Royal Navy Treatment Table 66 (Figure 2).

Side effects occur infrequently, but myopia, ear barotrauma, and rarely oxygen toxicity have been reported.

As antibiotics become less available, and clinician time and complex dressings become more expensive, use of hyperbaric oxygen as a means of treating a variety of wound types may become an increasingly appropriate option for treatment.

During HBOT, patients are placed in a multiplace or monoplace chamber where they are required to breath 100% oxygen intermittently, at a pressure greater than sea level (ie, Patients with chronic wounds selected for HBOT usually have a history of nonresponsiveness to conventional treatments, including antibiotics and topical dressings, and failed debridement.

Patient selection for HBOT can be assisted by noninvasive transcutaneous oxygen pressure (Tcp O One of the major functions of HBOT is to supply wound tissue with sufficient oxygen to encourage metabolism in the wound environment, especially when the vascular supply is impaired.

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