Hyperbaric Oxygen Therapy: Applications

Chronic infections, slow-healing wounds, or complications after orthopedic surgery can slow down your recovery and limit your mobility. Whether you're active, play sports, or are in post-operative recovery, you need clear medical solutions backed by studies.

Hyperbaric oxygen therapy (HBOT) is one of these options. Doctors use it as an adjuvant therapy in difficult infections, especially where tissues are poorly oxygenated. Find out how it works, in which situations it is recommended, and what a proper evaluation before treatment involves, below.

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What is hyperbaric oxygen therapy and how does it work?

HBOT involves administering 100% oxygen inside a hyperbaric chamber, at a pressure higher than normal atmospheric pressure (usually 2-3 ATA). "Therapeutic oxygen" means pure oxygen, administered in a controlled way, for medical purposes. "Pressure" refers to the force with which the gas acts on the body. Under these conditions, oxygen dissolves in the blood plasma in a higher quantity and reaches the affected tissues more easily.

A session lasts, in most cases, 90 minutes. The full protocol can include 10, 20, or over 30 sessions, depending on the diagnosis and clinical response. The doctor establishes the protocol after a detailed evaluation, which includes medical history, tests, and imaging investigations.

If you want to understand exactly how the procedure is carried out, you can check the information about hyperbaric therapy within the dedicated medical rehabilitation services.

Patients in a hyperbaric oxygen therapy chamber

The antimicrobial mechanism of HBOT

Increasing oxygen concentration in tissues

Many chronic infections occur in areas with reduced circulation and tissue hypoxia (low oxygen levels). Anaerobic bacteria thrive easily in this environment. HBOT increases the oxygen level in the tissue and changes the local environment, which limits the multiplication of certain germs.

According to current data, increasing the partial pressure of oxygen inhibits the growth of anaerobic bacteria and supports the body's natural defense mechanisms.

Formation of reactive oxygen species

Under hyperbaric conditions, the body produces reactive oxygen species (ROS), such as hydrogen peroxide. These molecules can affect the structure of bacteria, including their membrane and genetic material.

Experimental studies show that this oxidative stress contributes to lowering the bacterial load, especially in persistent infections. The effect depends on the dose and duration of the therapy, which is why the protocol must be personalized.

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Supporting the immune system

Neutrophils, the cells involved in destroying bacteria, work more efficiently in a well-oxygenated environment. HBOT improves their ability to phagocytize and destroy germs. Hyperbaric oxygen therapy can reduce swelling and modulate the inflammatory response, which helps tissues heal under better conditions.

Synergy with antibiotics

In severe infections, HBOT does not replace antibiotics, but it can support their action. Some antibiotics work more effectively in an aerobic environment. By increasing local oxygenation, hyperbaric therapy can facilitate the penetration of medications into poorly vascularized areas. For the best results, the infectious disease doctor and the medical rehabilitation specialist work together and adapt the treatment plan.

6. The effectiveness of hyperbaric oxygenation

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Clinical applications in infections and recovery

Diabetic foot and infected ulcers

People with diabetes can develop foot lesions, with a risk of infection and slow healing. Tissue hypoxia delays regeneration.

In selected cases, HBOT can increase the healing rate of deep ulcers. The use of hyperbaric therapy is considered an adjuvant option in advanced diabetic ulcers, after a strict evaluation. If you have diabetes and wounds that aren't healing, find out about the available options and talk to a specialist.

Chronic osteomyelitis

Osteomyelitis is a bone infection, often difficult to treat due to reduced blood supply. HBOT can increase oxygen concentration at the bone level and can support antibiotic and surgical treatment. For active patients or athletes who want to regain their mobility, early intervention and a combined approach increase the chances of functional recovery.

Post-operative infections and reconstructions

After orthopedic or plastic surgery, some wounds can heal slowly or become infected. In reconstruction procedures with grafts and flaps, proper tissue oxygenation influences their integration.

In such situations, hyperbaric therapy can be part of the complex treatment plan, established individually by the medical team.

Other indications in recovery

HBOT is not only for infections. In certain cases of femoral head necrosis or in stroke recovery programs, doctors can include it in the treatment plan, alongside physiotherapy, physical therapy, and medication. The goal is to support tissue regeneration and optimize function.

Safety, risks, and contraindications

HBOT is considered a safe procedure when performed in a specialized center, with verified equipment and trained staff. However, there are risks and limitations. Possible adverse reactions:

ear barotrauma (pain or a feeling of pressure in the ears);
sinus discomfort;
claustrophobia;
transient visual disturbances;
rarely, oxygen toxicity.

The main absolute contraindication is untreated pneumothorax. There are also relative contraindications, such as acute ENT infections, uncontrolled lung conditions, or certain oncological treatments. The doctor identifies these situations during the consultation.

A proper evaluation makes the difference. Do not start the therapy without a medical recommendation. Each case requires an individual analysis, especially if you are in post-operative recovery or have chronic conditions!

Why do early intervention and a personalized approach matter?

Chronic infections and poorly oxygenated injuries respond better to treatment when you intervene early. Delaying can lead to complications and a longer recovery period.

At Centrokinetic, the multidisciplinary team reviews your medical history, investigations, and functional goals. You receive a personalized plan, tailored to your activity level and associated condition. Monitoring throughout the sessions allows the protocol to be adjusted for effectiveness and safety.

Talk openly with the doctor about expectations, risks, and alternatives. The final decision belongs to the specialist, based on medical criteria. Book an appointment now for a specialist consultation!

Frequently asked questions

Can HBOT replace antibiotics?

No. In infections, hyperbaric therapy complements antibiotic treatment and, if needed, surgery. The doctor establishes the right combination for your situation.

How many sessions are needed?

The number varies depending on the condition and the individual response. In chronic infections, the protocol can include 20-40 sessions. Periodic evaluation allows the plan to be adjusted.

Is the therapy painful?

The procedure is not painful. You may feel pressure in your ears, similar to what you feel during a flight. The medical staff explains the equalization techniques and monitors you continuously.

Disclaimer: This material is strictly for informational purposes and does not replace a specialist medical consultation. The information presented should not be used to diagnose or treat a condition without a doctor's recommendation. For any health issue, schedule a consultation and follow the instructions of qualified medical staff!

Centrokinetic is the place where you will find clear answers and effective solutions for musculoskeletal conditions. Our clinic, dedicated to musculoskeletal disorders, is organized into the following specialized departments:

Orthopedics, a department composed of a highly experienced team of orthopedic surgeons specializing in sports traumatology.
Pediatric Orthopedics, where sports injuries in children (ligament and meniscus injuries), spinal deformities (scoliosis, kyphosis, hyperlordosis), and foot deformities (hallux valgus, hallux rigidus, equinovarus foot, flatfoot, cavus foot) are treated.
Neurology, featuring a state-of-the-art department where consultations, electroencephalograms (EEG), and electromyography (EMG) examinations are performed.
Medical Rehabilitation for adults and children, a department specialized in the rehabilitation of professional athletes, spinal disorders, and children with neurological and traumatic conditions. Our extensive experience includes treating more than 5,000 professional athletes.
Medical Imaging, with the clinic equipped with ultrasound and MRI systems dedicated to musculoskeletal conditions, complemented by an experienced radiologist, Dr. Cosmin Pantu, specialized in musculoskeletal imaging.
Rheumatology, a comprehensive department dedicated to the diagnosis, treatment, and rehabilitation of patients with non-surgical musculoskeletal disorders.
Vascular Surgery, a highly specialized department focused on the diagnosis and treatment of vascular diseases affecting arteries, veins, and lymphatic vessels.
Psychology and Speech Therapy. Neurological and musculoskeletal conditions can have a psychological impact on patients, which is why we believe complete recovery requires addressing both the physical condition and its psychological consequences.
Neurofeedback. This innovative method helps improve concentration, reduce anxiety, and achieve emotional balance through a simple and interactive process.

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Sources:

"Hyperbaric Oxygen Therapy - Mayo Clinic." Mayoclinic.Org, 2026, https://www.mayoclinic.org/tests-procedures/hyperbaric-oxygen-therapy/about/pac-20394380. Accessed Apr. 28, 2026.
"Hyperbaric Oxygen Therapy." Cleveland Clinic, 31 Aug. 2023, https://my.clevelandclinic.org/health/treatments/17811-hyperbaric-oxygen-therapy. Accessed Apr. 28, 2026.
Memar MY;Yekani M;Alizadeh N;Baghi HB. "Hyperbaric Oxygen Therapy: Antimicrobial Mechanisms and Clinical Application for Infections." Biomedicine & Pharmacotherapy = Biomedecine & Pharmacotherapie, vol. 109, 2019, https://pubmed.ncbi.nlm.nih.gov/30399579/, 10.1016/j.biopha.2018.10.142. Accessed Apr. 28, 2026.
Dittmar Chmelař, et al. "Synergistic Application of Antibiotics and Hyperbaric Oxygen Therapy." Medical Gas Research, vol. 16, no. 2, 18 Aug. 2025, p. 176, https://pmc.ncbi.nlm.nih.gov/articles/PMC12413880/, 10.4103/mgr.MEDGASRES-D-25-00086. Accessed Apr. 28, 2026.