The Role of Hyperbaric Oxygen Therapy (HBOT) in Diabetic & Wound Care Clinics
In diabetic and wound care clinics, HBOT may be considered as an adjunctive treatment for carefully selected, difficult-to-heal wounds—particularly within a multidisciplinary diabetic-foot pathway. It is not a replacement for debridement, off-loading, infection control, vascular assessment, pressure redistribution, glucose management or patient education. The clinical question is whether a patient has a recognised indication and whether HBOT adds value to a comprehensive wound plan.
For specialist services, a hyperbaric chamber can support a structured, clinician-led pathway for patients whose wounds remain at risk despite appropriate standard care. Careful selection is essential: the term “non-healing wound” alone should not be used as an automatic reason to treat.
How HBOT Works in Wound Care
HBOT exposes the patient to prescribed oxygen at pressures above normal atmospheric pressure. The intended contribution is to support healing biology in an appropriately selected clinical context, while the wound team continues to address the causes that prevent healing.
- Tissue oxygenation. HBOT can increase oxygen delivery where tissue oxygen is limited.
- Healing support. It does not remove vascular, infectious, mechanical or metabolic barriers to healing.
- Multidisciplinary review. Vascular, podiatry, diabetes, infectious-disease, surgical and wound-care input may all be needed.
Applications in Diabetic & Wound Care
Selected Diabetic Foot Ulcers
For selected patients whose ulcer has not responded adequately to high-quality standard care, HBOT may be considered by the responsible clinician as an adjunct.
Compromised Grafts and Flaps
HBOT may be integrated promptly into the surgical team’s pathway rather than used in isolation.
Complex Infection Pathways
Source control, antimicrobial therapy and specialist oversight remain fundamental.
Safety and Considerations
Diabetes-specific protocols are particularly important. Before treatment, the team should establish a plan for blood-glucose monitoring, nutrition, medicines and recognition of hypoglycaemia. Patients also need screening for ear and sinus issues, lung conditions, medication interactions, confinement anxiety and other potential contraindications or precautions.
Evidence and Research
HBOT is not a generic wound-healing solution. Evidence, patient selection and service commissioning differ by wound type and clinical setting. It may be considered in selected cases after, or alongside, appropriate standard care; it does not guarantee ulcer closure, limb preservation or a particular healing timeframe.
Frequently Asked Questions: HBOT in Diabetic & Wound Care Clinics
Does HBOT heal every diabetic foot ulcer?
No. HBOT is not suitable for every diabetic foot ulcer and should not be presented as a stand-alone cure. A clinician must assess the ulcer, circulation, infection, pressure exposure, diabetes control, existing wound care and potential role of HBOT.
What wound care continues during a course of HBOT?
Patients usually continue debridement, dressings, off-loading, vascular or surgical review, infection treatment, podiatry care and diabetes management.
Can people using insulin have hyperbaric treatment?
They may be able to, subject to individual assessment and a clear glucose-management protocol.
How should a wound clinic assess whether HBOT is helping?
The clinical team should review wound size and tissue quality, infection and perfusion status, adherence to off-loading, and progress against agreed goals.
Conclusion
A hyperbaric service can strengthen a diabetic and wound care clinic’s capability when it is embedded in multidisciplinary assessment and robust follow-up. The priority is to identify the right patients, maintain high standards of wound care and safety, and monitor meaningful outcomes.