What is a Comprehensive Wound Healing Center?
A Comprehensive Wound Healing Center is an outpatient department of an acute
care hospital providing medical evaluation of patients with wound healing
problems and specialized treatment of these wounds using the most advanced
techniques, products and services. The Comprehensive Wound Healing Center is
staffed by a specially trained team of doctors, nurses and other health care
workers dedicated to the treatment of wound healing problems. Most treatments,
including hyperbaric oxygen treatment, are provided in an outpatient setting.
Why is a special center for treating wounds beneficial?
Comprehensive Wound Healing Centers fulfill the needs of patients who require
specialized and aggressive care for their wounds that typically cannot be
provided in traditional medical settings. Published medical and nursing evidence
suggests that specialized centers for treating wounds improve outcomes by
providing early and coordinated access to the full range of medical, surgical,
and nursing interventions that may be required.
How many people have chronic, non-healing wounds?
It is estimated that nearly 5 million Americans suffer from chronic wounds
including those that are the result of diabetes, lower extremity arterial
disease, lower extremity venous disease and edema, and pressure ulcers, and
How do I know if I have a chronic, non-healing wound?
If a wound has not improved significantly in four weeks or if it has not
completed the healing process in eight weeks, it should be considered a chronic
wound and one at risk for prolonged non-healing. Patients who have diabetes,
arterial disease or chronic edema of the lower extremities, or a history of
collagen vascular disease such as scleroderma or rheumatoid arthritis should
seek early referral to a Comprehensive Wound Healing Center.
What are the causes of chronic wounds?
Diabetes, immobilization, chronic edema, and circulatory problems contribute to
the majority of chronic, non-healing wounds. Approximately 1.5 million people
with non-healing wounds have diabetes. Another 2.5 million patients have
pressure ulcers. Each year 500,000 new lower extremity ulcers develop in patient
with chronic venous insufficiency and stasis. Other chronic wounds are the
result of traumatic injury, non-healing surgical incisions, and a variety of
other diseases that affect the skin.
How do I seek treatment?
If you are suffering from a non-healing wound, approach your doctor about other
options you may have. You may also contact Praxis Clinical Services directly or
utilized the "How to Find a PCS Center" portion of this website to locate the
Comprehensive Wound Healing Center nearest you.
What is hyperbaric oxygen treatment?
Hyperbaric oxygen treatment is the breathing of 100 per cent oxygen at a
pressure greater than one atmosphere, the pressure of air at sea level. In order
to accomplish this treatment, a patient must be enclosed in a specially
constructed chamber. Two types of chambers are commonly used to treat patients.
The majority of hyperbaric oxygen treatments are administered in monoplace
hyperbaric chambers holding a single patient and made of acrylic and filled with
100 per cent oxygen. Patients may also be treated in multiplace chambers that
are typically larger, hold multiple patients, and are filled with air. Patients
in multiplace chambers breathe 100 per cent oxygen by wearing a mask or hood
during treatment. Hyperbaric oxygen treatment was originally used to treat
divers suffering from the "bends" or decompression sickness but is now used to
treat patients with a variety of wound healing problems including certain
chronic bone infections (osteomyelitis) and certain rapidly progressive acute
infections such as those caused by "flesh eating" bacteria (necrotizing
What is hyperbaric oxygen treatment used for?
Hyperbaric oxygen treatment may be used to treat a number of clinical
conditions. The Undersea and Hyperbaric Medical Society’s Oxygen Therapy
Committee has recommended hyperbaric oxygen treatment as beneficial in the
following clinical conditions including:
Air or gas embolism
Carbon monoxide poisoning
Crush injury, compartment syndrome,
and other acute traumatic ischemic injuries
Compromised skin grafts or flaps
Other problem wounds complicated by hypoxia
and specifically diabetic foot ulcers
Necrotizing soft tissue infections
Soft tissue radionecrosis
How does hyperbaric oxygen treatment it work?
Normally the air we breathe contains 21 per cent oxygen. We are surrounded by a
column of air stretching from the surface of the earth to infinity exerted a
pressure that we refer to as sea level pressure or one atmosphere of pressure.
During hyperbaric oxygen treatment 100 per cent oxygen is breathed at a pressure
greater than sea level pressure or greater than one atmosphere of pressure. This
increases the amount of oxygen dissolved in the liquid portion of the blood,
plasma, as much as three to five times over what is possible breathing oxygen at
sea level pressure. The resulting increased oxygen carrying capacity is
delivered to all tissues where there is sufficient blood flow and produces a
number of beneficial effects that improve the body’s elimination of certain
poisons such as carbon monoxide, improved the body’s response to infection and
support tissue growth and wound healing.
Are there any side effects or after effects of hyperbaric oxygen treatment?
The most common side effects are related to the direct effects of the pressure
change during compression on the middle ear. If not recognized and managed
effectively, injury to the ear drum (tympanic membrane) can occur. Oxygen
breathing at increased pressure may also produce acute toxic reactions that are
reversible and usually preventable by adjusting the oxygen dosing schedule. Side
effects and potential complications will be discussed in detail with you by your
physician prior to treatment.
What are hyperbaric oxygen treatments like?
Hyperbaric oxygen treatments include three phases: compression to the prescribed
treatment pressure, the prescribed time at pressure, and decompression from the
treatment pressure back to surface or atmospheric pressure.
Compression: During the compression phase patients feel a "fullness" in their
ears similar to what is experienced as a commercial airliner lands. This
increase in pressure on the tympanic membrane or ear drum must be equalized by
performing a valsalva maneuver or be swallowing or yawning. The temperature in
the chamber also increases slightly during compression.
Treatment: The treatment phase begins when the pressure reaches the prescribed
level. The patient breathes 100 per cent oxygen with brief interruptions to
breath air to reduce the risk of any toxic reaction to prolonged oxygen
breathing. During the treatment patients may rest, sleep, listen to music, or
Decompression: During decompression the pressure within the chamber is reduced
to that at the surface. Decompression results in mild cooling. Once the chamber
pressure equals the outside or surface pressure the treatment is completed and
the patient is removed from the chamber.