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Posts for: December, 2014

Podiatrists commonly battle with chronic foot ulcers and venous leg ulcers in their everyday practice. Whether they are diabetic foot ulcers or a traumatic wound that fails to heal properly, these wounds can cause severe disability and may even result in limb loss or death. Complications like infections, poor blood supply, some genetic diseases, and poor oxygenation of the wound can all lead to a chronic, tough to heal wound.

Hyperbaric Oxygen Therapy (HBOT) is a type of immersive treatment modality that has been in existence for many years, but is now seeing a resurgence in popularity. Originally invented to treat divers with the ‘bends’ or diving sickness, HBOT involves increasing the atmospheric pressure around the patient and essentially ‘forcing’ pure oxygen into the tissues that need healing.

In the outpatient setting, HBOT is used for patients with chronic wounds, severe burns, radiation burn wounds, and even bone infections. Usually these conditions require a compression time of around 90 minutes and a pressure increase of up to 2 atmospheres – the equivalent pressure of being ten feet under water!The diving sickness and a condition called an Arterial Gas Embolism are emergencies and HBOT is usually performed under higher pressures with longer compression times in those cases.

While this may sound a bit alarming to some, the process is performed in a special chamber or ‘dive-tank’ at a certified wound care center with many specialists on staff to care for you and manage your treatment. 

(This picture shows a patient resting comfortably in a HBOT chamber. Photo from

Diabetic foot ulcers (DFUs) are somewhat unique in that the consequences of the disease cause the wounds to form and create a poor environment for wound healing.  Inability to feel the wound developing, decreased tissue strength, and poor blood flow due to small vessel disease all contribute to these DFUs. They most commonly develop under areas of pressure on the foot and may be chronically infected, which prevents some types of treatments from working properly. 

(This illustration depicts what a DFU under the metatarsal heads and the big toe. Image from  

The best way to heal chronic DFUs and leg ulcers is to see your podiatrist and develop a plan to control blood sugar levels, eat a healthy diet and formulate a “plan of attack” against the wounds. While being treated at a wound care center, you can meet your doctor for the weekly sessions as needed, and utilize the instrumentation and excellent wound care staff to make your wounds a thing of the past! 

(Healing wounds like these and protecting your life and limbs is our goal! And this can all be achieved with diligence and proper wound care. Image from 

Dr. Garibaldi has had years of practice treating stubborn and hard to heal wounds. He is certified in Hyperbaric Oxygen Therapy and has excellent working relationships with local wound care centers. If you or someone you know needs personalized and professional wound care, give us a call today!


Wilmshurst Peter. ABC of oxygen BMJ 1998;317:996

Tibbles, P and Edelsberg, J. Hyperbaric-Oxygen Therapy, N Engl J Med 1996; 334:1642-1648

Goldman RJ.Hyperbaric oxygen therapy for wound healing and limb salvage: a systematic review. PM R. 2009 May;1(5):471-89. doi: 10.1016/j.pmrj.2009.03.012.