How Hyperbaric Oxygen Therapy Promotes the Acceleration of Impaired Healing

Hyperbaric Oxygen Therapy

Many patients complain of slow-healing wounds, which are annoying and aesthetically unpleasant. An injury that takes longer to heal is at a higher risk of getting infected. Hyperbaric oxygen therapy (HBOT) in treating wounds and infections enhances healing while significantly decreasing amputation risk. At Wound Evolution – Wound Care and Hyperbaric Medicine, Dr. Ashley Huddleston in Fort Worth provides this adjunctive therapy to minimize chronic wound inflammation and improve oxygenation and neovascularization in the affected area.

The three phases of Normal Wound Healing

  1. Hemostasis

Platelets attach to the endothelium as soon as you are injured.

Hemostasis is the process where platelet coagulation leads to the formation of a wound matrix.

  1. Inflammation

This process involves transferring and activating leukocytes, neutrophils, and macrophages and lasts a few days after the injury. The inflammatory response cells then undergo apoptosis.  

  1. Proliferation

This stage involves neovascularization which takes place through vasculogenesis. Vasculogenesis is the differentiation of recruited endothelial progenitor cells from the bone marrow through a process called angiogenesis. The process results in the formation of capillary-forming endothelial cells, which eventually form new blood vessels.

It is crucial for robust neovascularization to occur because it promotes granulation tissue formation, which supplies oxygen and nutrients to the dermal and epidermal cells proliferating in the wound bed. Fibroblasts are the most critical proliferating cells because they lead to the formation of a wound matrix which causes the closure of connective tissue providing mechanical strength to the wound.

  1. Maturation

This final phase involves the formation of scar tissue via wound contraction and matrix remodeling. Wounds that undergo a more prolonged inflammatory phase become chronic because they cannot move into the proliferative phase, which is crucial in forming new vascularized granulation tissue.

The mechanism of hyperbaric oxygen therapy

The HBOT procedure works under Henry’s law that the amount of ideal gas dissolved in the solution is directly proportional to its partial pressure. Elevating the partial oxygen pressure a patient inhales by administering 100% oxygen, the oxygen volume that can be dissolved in the bloodstream increases.

Chronic hypoxia in a wound is usually due to reduced wound healing. During treatment, the oxygen demand and utilization rates are increased, and arterial oxygen tension surpasses 2000 mm Hg as oxygen levels of 200-400 mm Hg occur in tissues causing tissue repair and wound healing.

The use of HBOT in promoting wound healing is beneficial because tissues cannot store oxygen. Increased oxygen concentrations increase reactive nitrogen and oxygen, facilitating the transition of a wound from the inflammatory stage to the proliferative phase by stimulating the signaling pathways responsible for promoting neovascularization, forming a wound matrix, and decreasing inflammation. Neovascularization is possible through hyperbaric oxygen therapy because the treatment encourages creating a concentration gradient between lowly and highly oxygenated tissues. Furthermore, reactive oxygen and reactive nitrogen promote wound growth factors, like the vascular endothelial growth factor, which plays a significant role in neovascularization. Hyperbaric oxygen exposure on endothelial cells enhances oxidative stress resistance and promotes capillary tube formation.

You can get more information about wound healing and the role of hyperbaric oxygen therapy by contacting Wound Evolution – Wound Care and Hyperbaric Medicine.


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