Problem wounds are those which fail to respond to established medical and surgical management. Such wounds usually develop in patients with multiple local and systemic factors contributing to poor tissue healing. These include diabetic foot ulcers, compromised amputation sites, vascular insufficiency ulcers (ulcers with poor circulation) and non-healing traumatic wounds. All share the common problem of tissue hypoxia (low tissue oxygen levels), usually related to impaired circulation.
Diabetic foot wounds are one of the major complications of diabetes and an excellent example of the type of complicated wound which can be treated with hyperbaric oxygen. Many diabetics have impaired arterial circulation in their feet and have great difficulty with wound healing of foot ulcers.
The elevation in tissue oxygenation which occurs in the hyperbaric chamber induces significant changes in the wound repair process that promote healing. When the hyperbaric chamber is used in conjunction with standard wound care, improved results have been demonstrated in the healing of difficult or limb threatening wounds.
Successful care of problem wounds requires an integrated team approach using surgery, antibiotics, physical therapy together with adjunct hyperbaric therapy when appropriate. Plastic and reconstructive surgeons, vascular surgeons, rehabilitation physicians and hyperbaric physicians work together at Jacobi as an integrated wound care team to cure problem wounds.