Hyperbaric oxygen abuse

Hyperbaric oxygen therapy has been criticized for being overused for increasing corporate profits.Now a new study came out revealing the dark side of hyperbarics. Unfortunately it can be an overused modality that does not have the patient’s best interest in mind. You have a wound and get a referral to a wound care center. The doctors there tell you you need 20 to 25 hyperbaric dives to heal your ulcer. Besides the underlying corporate greed you also need to be very aware of the potential physical hazards. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5467109/ The list of possible complications with hyperbarics treatment can be frightening. Collapsed lungs, ruptured eardrum, Sinus barotrauma, paranasal barotrauma, CNS toxicity, pulmonary toxicity, hyperoxic myopia, cataracts, nerve damage and claustrophobia are just to name a few. The article goes in depth as to all the possibilities as to what can go wrong. Too often hyperbarics is taking the place of proper wound care. I lecture around the country with other doctors and hear them constantly complaining how the patients that are getting hyperbarics are not getting proper surgical debridements. That the patients are not getting timely consult with plastics, vascular and podiatry. These fields are trained to close the wounds via skin grafts and flaps. It is common that patients getting hyperbarics are discouraged from getting VAC and negative pressure therapy. I recently heard this sentiment from a very respected

Foot gangrene

local plastic surgeon. What blows my mind is that there are thousands of peer reviewed published articles showing without a doubt negative pressure can close wounds months faster. With barely any good data supporting hyperbarics for wounds.

Hyperbaric oxygen abuse

At this point you may be asking how is this so. Here is hyperbarics dirty little secret. When you are prescribed hyperbarics by a wound care center more often than not they have a very big financial interest involved in getting you to do the treatment. There are some large wound care companies that will place the hyperbarics machines by the hospital and with creative contracting that give financial benefits to all involved. This financially will help the hospital and wound care center because medicare pays a large amount for a hyperbaric dive. On average you can spend 3 hours a day to get into the hyperbarics machine ( that includes getting to the facility getting onto the machine and getting home). Medicare has documented over use of this treatment. Studies have questioned its benefits. The American Diabetes Association has stated by its experts that there is not enough data to show that hyperbarics works for diabetic wounds.

I am not saying that hyperbarics is not ever indicated. One should always get a second opinion from a plastic , vascular or podiatric surgeon if there as a way to close the wound quicker and more effectively.

Hyperbaric oxygen abuse

Here is the article published by kaiser health news  discussing the corporate interests in hyperbarics https://khn.org/news/hospitals-put-more-stock-in-hyperbaric-therapy-for-diabetics-despite-concerns/

Here is one from the Washington Post https://www.washingtonpost.com/national/health-science/hyperbaric-wound-treatment-often-for-diabetics-is-booming-is-that-a-good-thing/2017/06/23/972d50a6-5065-11e7-be25-3a519335381c_story.html?utm_term=.936344b96662