Last updated on 07 April 08

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Hyperbaric medicine, also known as hyperbaric oxygen therapy (HBOT) is the medical use of oxygen at a higher than atmospheric pressure. Hyperbaric is the only technique available to overcome the natural limit of oxygen solubility in blood. The hyperbaric procedure is done in specially designed chambers that permit the delivery of 100% oxygen at ambient pressures that are greater than atmospheric. This allows dissolved oxygen in the blood and clear fluids to be increased by up to 20 times normal levels. This additional oxygen in solution is almost sufficient to meet tissue needs without contribution from oxygen bound to hemoglobin and is responsible for most of the beneficial effects of this therapy. Severe thermal injury is one of the most devastating physical and psychological injuries a person can suffer. The most common mechanisms of burn injury are flame and scalding and the upper extremity, head and neck are the most common body areas involved. The burn wound is a complex, dynamic injury characterized by a zone of coagulation surrounded by an area of stasis and bordered by an area of erythema (redness of the skin produced by congestion of the capillaries). The continuing damage in thermal injury is due to the failure of the surrounding tissue to supply borderline cells with oxygen and nutrients necessary to sustain viability. Susceptibility to infection is greatly increased due to the loss of the integument barrier to bacterial invasion and the compromised microvasculature which prevents the needed elements from reaching the injured tissues. Regeneration cannot take place until equilibrium is reached, hence, healing is retarded and prolongation of the healing process may lead to excessive scarring. HBOT has been known to limit the progression of the burn injury, reduce swelling, reduce the need for surgery, diminish lung damage, shorten hospitalization and overall cost savings. These benefits are more apparent if therapy is initiated within 6-24 hours of the burn injury. Indications for HBO therapy include deep second-degree and third degree burns that involve greater than 20% of the total body surface area, and less extensive burns that involve the face, hands or groin area. When burn victims are not hospitalized with non life threatening burns, HBOT can be carried out at private facilities when first or second degree burns are involved.