For a wound that is not healing, start with our condition guide to chronic non-healing wounds: why a wound stays open, what to check first, and what UK guidance says. There are also guides to radiation tissue injury, osteomyelitis and compromised skin grafts and flaps.
Why some wounds refuse to heal
Healing is one of the most oxygen-demanding things the body does. Building new tissue, producing collagen, fighting bacteria and growing new blood vessels all depend on a steady oxygen supply. When circulation to a wound is compromised, that supply falls short and healing stalls.
This is exactly what happens in many chronic wounds. In diabetic foot disease, reduced circulation, neuropathy, pressure, infection and impaired tissue repair can combine to create wounds that struggle to heal. After radiotherapy, treated tissue can be left permanently short of blood supply. Pressure, poor veins and infection can do the same. The result is a wound that stays open for months, resists standard care and carries a growing risk of serious infection.
How HBOT supports wound healing
Hyperbaric Oxygen Therapy can increase oxygen availability within compromised tissues, supporting biological processes involved in wound healing. Breathing oxygen through a mask under increased pressure dissolves oxygen straight into blood plasma, which reaches compromised tissue far more effectively than oxygen carried by red blood cells alone. If you are new to HBOT, our guide to what Hyperbaric Oxygen Therapy is covers the fundamentals.
Over a course of sessions, this changes the wound environment in several ways:
- Oxygenates the wound bed, giving cells the fuel they need to rebuild tissue and produce collagen
- Stimulates new blood vessel growth (angiogenesis), so the improvement persists between and after sessions
- Supports infection control, because white blood cells kill many bacteria far more effectively in oxygen-rich tissue
- Reduces swelling around the wound, easing pressure on already-compromised circulation
Wounds where HBOT is used
- Diabetic foot ulcers that have not responded to good standard care
- Late radiation tissue injury, including damage following radiotherapy to the head, neck, chest or pelvis
- Compromised skin grafts and flaps, where tissue is struggling to establish blood supply
- Selected chronic non-healing or ischaemic wounds, following appropriate vascular and wound assessment.
- Certain serious soft-tissue infections, as part of wider hospital care
What the evidence says
Wound healing is one of the most established areas of hyperbaric medicine. HBOT is included in international hyperbaric guidance for selected diabetic foot ulcers that have not responded adequately to standard wound care. However, evidence remains mixed and current NICE guidance does not recommend HBOT for diabetic foot ulcers outside a clinical trial. HBOT does not replace multidisciplinary diabetic foot care, vascular assessment, offloading, infection management or appropriate wound treatment. For diabetic foot ulcers specifically, European guidance is explicit that HBOT should not be a stand-alone therapy.
The key word is selected. HBOT is not appropriate for every wound, and it works as an addition to good standard care rather than a replacement for it. A reputable provider will assess the wound, the underlying causes and your wider health before recommending treatment. That assessment is built into our treatment pathway.
What a course of treatment looks like
Chronic wounds are treated with a structured course rather than one-off sessions, because the biological changes that matter, particularly new blood vessel growth, build gradually with repeated exposure.
- Assessment first. Your medical history, the wound itself and its underlying causes are reviewed to confirm HBOT is appropriate.
- A defined course. Many wound-healing protocols involve approximately 20–40 sessions, although the number, pressure and duration are prescribed individually according to the condition, treatment protocol and clinical response.
- Alongside standard care. Dressings, debridement, offloading and management of underlying conditions all continue. HBOT complements them.
- Progress reviews. The wound is monitored throughout, and the plan is adjusted or concluded based on how it responds.
At Heal & Go₂, treatment is delivered in hospital-based Centres of Excellence under clinical oversight, and where you are already under the care of a GP, consultant, podiatrist or wound-care nurse, we work alongside them rather than around them.
Common questions
Can HBOT help diabetic foot ulcers?
HBOT is included in international hyperbaric guidance for selected diabetic foot ulcers that have not responded adequately to standard wound care. It is used as an addition to good standard care, such as offloading, dressings and blood-sugar management. Evidence remains mixed and current NICE guidance does not recommend HBOT for diabetic foot ulcers outside a clinical trial, and European guidance is explicit that HBOT should not be a stand-alone therapy. Suitability is always assessed case by case.
How many HBOT sessions are needed for wound healing?
Chronic wounds are typically treated with a structured course, often in the range of 20 to 40 sessions delivered several times a week. The exact number depends on the wound, your response to treatment and your wider care plan, and progress is reviewed throughout.
Does HBOT replace standard wound care?
No. HBOT works alongside standard wound care, not instead of it. Dressings, debridement, offloading, infection management and treatment of underlying causes all continue. HBOT adds oxygen delivery that compromised tissue cannot achieve on its own.
Is HBOT suitable for every wound?
No. HBOT is most useful where poor oxygen supply is holding healing back, and every patient is clinically screened first. Wounds with untreated underlying causes, or patients with certain lung or ear conditions, may need those addressed before HBOT can be considered.
Related guides
This guide is for general information only and is not a substitute for professional medical advice. If you have a wound that is not healing, speak to your GP, consultant or wound-care team about your individual circumstances.