How oxygen is used to treat chronic wounds with hyperbaric oxygen therapy

St. Joseph’s/Candler Center for Hyperbarics and Wound Care offers a variety of treatments to help wounds heal faster

Oxygen is the colorless, odorless, gaseous element that keeps the human body functioning. But, oxygen at 100 percent pressurized also is a drug – one that is a proven cure of chronic wounds.

Hyperbaric oxygen therapy is a treatment method for wounds that do not respond to traditional wound care. Patients lie in a hyperbaric chamber (a big glass tube) and breathe in 100 percent pure oxygen. With pressurized oxygen it supersaturates your body with oxygen, says Dr. Thomas Donohue, M.D., medical director for Wound Care and Hyperbarics at the Candler and Hinesville centers, and allows for: 

• Decreased inflammation
• Development of new blood vessels to areas that that are not getting enough blood flow followed by improved blood flow that is necessary to heal
• Killing off any lingering bacteria

“Hyperbaric oxygen therapy is so helpful because most wounds are ischemic, meaning most wounds don’t have good blood flow, so when your body is put in a hyperbaric chamber it builds new blood vessels around wound tissues,” Dr. Donohue describes. “Once you get more blood flow you can deliver nutrition, antibiotics and oxygen that helps the wound itself clear out the infection, get rid of the bad tissue, build new tissue and heal.”

The common chronic wounds and conditions hyperbaric oxygen therapy are used for include chronic bone infection, diabetic lower extremity ulcers that are infected, radiation wounds, compromised or failed skin grafts or flaps, crush injuries and necrotizing infections.

Hyperbaric oxygen therapy has been around for decades; however, Dr. Donohue says a lot of people do not realize it exists. St. Joseph’s/Candler has been offering the treatment method for more than 20 years and is now available at three Center for Hyperbaric and Wound Care locations: Candler Hospital, Hinesville and Bluffton/Hilton Head.

What patients should expect during hyperbaric oxygen therapy

Medicare patients qualify for hyperbaric oxygen therapy if traditional wound care was not successful and their wound is one of about 13 Medicare approves treatment of. Appointments are required and can be physician or self-referred.

Patients should expect anywhere from 20 to 40 treatments, Dr. Donohue says. Treatments are daily Monday through Friday and typically last 90 minutes. A patient is never left alone while in the chamber.

“You can watch TV, watch a movie or sleep,” Dr. Donohue says. “Hyperbaric therapy actually makes you tired.”

Other treatments for wound care

Any wound can be helped by hyperbaric oxygen therapy with the right conditions, Dr. Donohue says. However, hyperbaric oxygen therapy is expensive and only about 10 to 15 percent of patients meet the Medicare requirements to qualify for hyperbaric treatment.

St. Joseph’s/Candler Center for Hyperbaric and Wound Care offers several other options to treat wounds effectively and timely.

“If you have a wound, we can help take care of it,” Dr. Donohue says. “Most wounds heal within about two weeks. You have a cut – it usually heals within two weeks. If you have surgery, they usually take the sutures or staples out in about two weeks and you go on your merry life. We take care of the wounds that don’t heal in those two weeks.”

Wounds that can be treated include burns, diabetic ulcers, ischemic ulcers, peristomal skin irritations, pressure ulcers, non-healing wounds from falls, medication reactions or other conditions, traumatic wounds, surgical wounds, venous insufficiency and C-section wounds.

The Association for the Advancement of Wound Care estimates more than 5 million Americans have a skin wound or ulcer. The majority are women, older adults and diabetic patients. A quarter of people with diabetes will develop a foot ulcer with more than 15 percent of those ulcers developing an infection in the bone.

A large percentage of patients treated at the SJ/C Center for Hyperbarics and Wound Care are diabetic patients, Dr. Donohue says, along with the elderly.

“If you look at most wound care centers across the country, you don’t see a lot of young people. Young people for the most part heal. The reason is they are young and healthy. Their arteries are open and not blocked, so they have good blood flow. Their nutrition is usually good. Their protein stores are usually good. Their cell turnover is still good,” Dr. Donohue says.

“Why you see at wound care centers mostly older folks is because their cells don’t work as well – that’s why they are getting older. Their blood flow probably isn’t as good because they’ve lived their lives and their pipes start to become blocked, just like an old house.”

Dr. Donohue also adds that smokers are more likely to have decreased healing times because smoking damages blood vessels. Immune-compromised conditions, such as renal failure, diabetes or taking steroids to treat rheumatoid arthritis, also can affect wound recovery time.

If you notice after two weeks a wound is not getting smaller, drainage is increasing and/or the wound doesn’t look clean or healthy, wound care can help you heal and avoid further complications. Available treatments include:

• Multiple advanced dressing options including:
  • Dressings with silver
  • Anti-bacterial dressings
  • Dressings with collagen
  • Dressings that put moisture in the wound
  • Dressings that pull moisture out of the wound
• Advanced skin substitutes
• Compression therapy
• Casting for diabetic foot ulcers
• Edema management
• Non-invasive vascular testing
• Pressure relief and offloading, such as suggesting special shoes, wound vacs, sponges or other advanced devices to use at home

In addition, the wound care center offers diabetic teaching, nutritional counseling and patient and caregiver wound management/prevention counseling.

What patients should expect during wound care treatment

Wound care typically requires a weekly visit until the wound is healed. The wound care treatment may vary from week to week as the wound heals. Dr. Donohue also advises patients that wound care often is painful.

“Sometimes it can be painful because there will be times when you have to actually clean out the wound,” Dr. Donohue says. “We do use numbing medicine but we don’t put people to sleep. Wound care is no fun, but it works.”

The SJ/C Center for Hyperbarics and Wound Care is open Monday through Friday. Appointments are required, but a physician’s referral is not necessary. We have locations at:

Candler Hospital
Heart and Lung Building, Suite 201
5353 Reynolds Street
Savannah, Ga. 31405
912-819-8187

Bluffton/Hilton Head
19 Moss Creek Village, Suite B4
Bluffton, SC 29926
843-837-9000

Hinesville
103B General Stewart Way
Hinesville, Ga. 31313
912-332-5612

The Center for Hyperbarics and Wound Care is an outpatient, non-emergency care facility. If you need immediate assistance, please call 9-1-1. To learn more about hyperbarics and wound care at St. Joseph’s/Candler, visit our website.