Hyperbaric oxygen therapy in the treatment of skin infections

Article reviewed by: Dr. Sturz Ciprian, Dr. Tîlvescu Cătălin and Dr. Alina Vasile

Hyperbaric oxygen therapy in the treatment of skin infections

Herpes, papillomas, folliculitis, furuncle, cellulitis are just some of the most common skin conditions. In the case of patients who do not suffer from other conditions, they heal quite easily and quickly. In the case of people with diabetes, for example, wounds and injuries heal with difficulty.

Thus, in the case of skin infections that persist despite treatment, hyperbaric oxygen therapy is the perfect solution to speed up the healing process. Skin infections can be acute or chronic and are caused by various pathogens: bacterial, viral, fungal, parasitic. They can affect different layers of the skin, including the epidermis (the outer layer), the dermis (the middle layer), or even the subcutaneous tissues (the layer under the skin).

Hyperbaric oxygen therapy (HBOT) helps treat these infections by increasing oxygen levels in affected tissues.

The benefits of hyperbaric oxygen

Increases oxygen concentration: The increased air pressure in the hyperbaric chamber leads to better diffusion of oxygen into the tissues, including areas affected by infection. Thus, cellular metabolism is improved.

Destroys bacteria: Hyperbaric oxygen therapy helps to block the action of harmful bacteria. Thus, by increasing the level of oxygen in the tissues, the destruction of bacteria or the slowing down of their development is facilitated.

Stimulates the immune system: A higher level of oxygen in the tissues helps the immune system work more effectively in fighting skin infections.

Promotes tissue healing: Oxygen is essential in the tissue healing process. By providing a greater amount of oxygen, HBOT contributes to faster healing of skin lesions.

Severe skin infections treated with HBOT

Several studies have shown that hyperbaric oxygen therapy is particularly beneficial in cases where there is a deficiency of blood and oxygen flow to the affected area.

Additional oxygen provided at elevated pressures helps fight bacteria and other microorganisms that cause infections. Moreover, hyperbaric oxygen increases the activity of immune system cells and improves healing processes.

Severe skin infections that benefit from hyperbaric oxygen therapy:

Gas gangrene: It is a serious bacterial infection characterized by rapid tissue damage. HBOT contributes to improving the oxygenation of affected tissues and supports the fight against bacteria, limiting the spread of infection and promoting healing.

Diabetic ulcer: People with diabetes can develop foot ulcers, and they can be prone to infections. HBOT is used to improve blood circulation and provide extra oxygen to the ulcer area, helping to heal faster and prevent infectious complications.

Necrotising cellulitis: This is a bacterial infection that can lead to rapid tissue damage and the development of necrosis. HBOT helps improve oxygen supply to affected tissues, supporting healing processes and reducing the spread of infection.

Skin abscesses: Oxygen therapy is recommended for the treatment of complicated skin abscesses. Increasing tissue oxygen levels helps fight bacteria and speed up the drainage and healing process.

Treatment for Diabetic Foot Infections

Diabetic foot infections (IPD) are the most common problems (40%-80%) encountered by the diabetic patient , representing a costly complication of skin ulcers or trauma in these patients. Thus, they may increase the risk of morbidity and mortality. These infections include skin tissue, soft tissue and bone structures. Studies indicate that during life a person with diabetes has a 25% risk of developing a foot ulcer.

According to research, poor oxygenation of skin tissue is the most common cause hospitalization of diabetic patients and one of the major causes of leg amputation. Thus, HBOT is one of the complementary options for the treatment of IPD. The use of HBOT was found to significantly increase the healing rate of diabetic foot infections and decrease the risk of foot amputation.

HBOT also decreased the need for other expensive surgical procedures such as flaps and grafts (common reconstructive procedures used for definitive treatment of surgical wounds). Thus, according to a study carried out in Taiwan, researchers reported that over 10 sessions of HBOT increased the wound healing rate by 78.3% in diabetic patients.

Another study published in DiabetesJournals.org compared the effects of hyperbaric oxygen therapy with standard care of diabetic foot wounds per 100 patients, which did not respond to a month of adequate treatment. Thus, a 66% cure rate was found after hyperbaric therapy sessions. Regarding the amputation rate of the lower limbs, it was only 8%, compared to 82% in the case of classical treatments.

Adjuvant method in the treatment of necrotizing infections

Necrotising soft tissue infections are polymicrobial infections commonly caused by the synergistic occurrence of different aerobic or anaerobic agents. Their evolution is often rapid and can cause a high mortality rate. A quick and appropriate diagnosis and treatment increase the chances of a favorable outcome. HBOT is recommended as an adjunctive method in the treatment of necrotizing tissue infections.

Another study conducted at the Medical University of Copenhagen, Denmark, showed that the administration of hyperbaric oxygen therapy as an adjuvant, twice a day, at an interval of 8 h, in combination with specific treatment, led to a decrease in the bacterial load in staphylococcal endocarditis, caused by Stafilococcus Aureus. This has a mortality rate of about 40%.

It is important to emphasize that hyperbaric oxygen therapy must be administered under the close supervision of a specialist physician and in an appropriately equipped medical facility.

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