Diabetic Foot Ulcer Brochure
Dressing Your Wound Brochure
Exercise Program Brochure
Neuropathic Foot Ulcer Brochure
Foot Care Brochure
HBO Therapy Brochure
Ischemic Ulcer Brochure
ORN Brochure
Pressure Ulcer Brochure
Smoking and Wound Healing Brochure
Snacking Guide Brochure
Choosing the Right Shoe Brochure
Venous Stasis Ulcers Brochure

Frequently Asked Questions

 1) What is a Comprehensive Wound Healing Center?
 2) Why is a special center for treating wounds beneficial?
 3) How many people have chronic, non-healing wounds?
 4) How do I know if I have a chronic, non-healing wound?
 5) What are the causes of chronic wounds?
 6) How do I seek treatment?
 7) What is hyperbaric oxygen treatment?
 8) What is hyperbaric oxygen treatment used for?
 9) How does hyperbaric oxygen treatment it work?
10) Are there any side effects or after effects of hyperbaric oxygen
11) What are hyperbaric oxygen treatments like?

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 traumatic injuries.

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 fasciitis).

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

Decompression sickness

Carbon monoxide poisoning

Cyanide poisoning


Crush injury, compartment syndrome,
and other acute traumatic ischemic injuries

Compromised skin grafts or flaps

Thermal burns


Other problem wounds complicated by hypoxia
and specifically diabetic foot ulcers

Necrotizing soft tissue infections

Gas gangrene

Refractory osteomyelitis


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 watch television.

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.



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