Dr. Jeffrey A. Niezgoda introduces the listener to the topic of Hyperbaric Oxygen Therapy.  The lecture begins with an overview of compromised wound healing and a detailed discussion of the critical role that oxygen plays in the healing cascade. Chronic wounds are stagnant between the inflammatory and proliferative phases, because of oxygen deficit. In the early injury phase of healing, the metabolic demands of tissue increase by a factor of 20 or more. Dr. Niezgoda explains the very significant role that oxygen plays in wound healing. All four wound healing phases are oxygen dependent. Collagen synthesis, which is so important in wound healing, will only occur with tissue oxygen tensions above 30mmHg. Oxygen promotes angiogenesis and is both bacteriostatic and bactericidal. 

Hyperbaric oxygen is a therapeutic mechanism in which the patient is placed in an enclosed  chamber in which 100% oxygen is inhaled in a systemic pressurized environment. The patient's blood and hemoglobin become hyper saturated with O², thereby affecting the stagnant wound in a positive way.  

Dr. Niezgoda details the physiology and mechanism of action of Hyperbaric Oxygen. The emergent indications such as carbon monoxide poisoning, decompression illness, and gas gangrene are reviewed. Routine indications such as osteomylelitis, compromised tissue flaps and grafts, and arterial insufficiency are also discussed.  

Contraindications, risks and benefits are presented. The large "aerospace like" multiplace chambers that come to mind when we think of decompression illness or gas embolism are no longer the norm.

A great many wound care centers now have, patient friendly, monoplace chambers, designed to augment healing.

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