Hyperbaric Oxygen Therapy for Chronic Wound Care in Concord, CA

A chronic non-healing wound is generally defined as a wound that has failed to progress through the normal phases of healing within four to six weeks of onset, despite appropriate standard care. These wounds are far more prevalent than most people realize: chronic wounds affect an estimated 6.5 million patients in the United States at any given time, consuming more than $25 billion in healthcare resources annually. They are a leading driver of hospitalizations, surgical procedures, and amputations in the American healthcare system.

Non-diabetic chronic wounds commonly seen at NorCal Hyperbarics include:

• Venous leg ulcers: The most common type of chronic lower-extremity wound, caused by venous insufficiency and ambulatory venous hypertension that creates a hostile, edematous environment for healing.

• Arterial (ischemic) ulcers: Wounds caused by peripheral arterial disease (PAD), where insufficient arterial blood flow deprives tissue of oxygen and nutrients.

• Pressure injuries (pressure ulcers / decubitus ulcers): Wounds resulting from sustained pressure on tissue over bony prominences, common in immobile or bedridden patients.

• Post-surgical wound dehiscence and non-healing surgical sites: Wounds that fail to close after surgery, particularly following cardiac surgery (sternotomy wounds), orthopedic procedures, and abdominal surgery.

• Compromised skin grafts and flaps: Grafts and reconstructive flaps that are failing due to inadequate vascular perfusion — an approved UHMS indication for HBOT.

• Crush injuries: Traumatic injuries with significant tissue devitalization that are at high risk of wound failure and infection.

All wound healing is fundamentally oxygen-dependent. Fibroblast proliferation, collagen synthesis, epithelial migration, angiogenesis, and bacterial killing by immune cells all require adequate tissue oxygen. In chronic non-healing wounds, these processes have stalled because tissue oxygenation — whether from arterial insufficiency, venous hypertension, pressure-induced ischemia, or post-radiation vascular damage — has fallen below the threshold needed to sustain normal healing biology. HBOT directly corrects this deficiency.

At 2.0 to 2.5 atmospheres of 100% oxygen, HBOT raises the dissolved oxygen content of blood plasma to levels that are independent of hemoglobin carrying capacity and sufficient to diffuse deep into even the most ischemic wound tissue. This elevated oxygen environment immediately supports leukocyte bactericidal function, stimulates fibroblast collagen production, and triggers the release of vascular endothelial growth factor (VEGF) — initiating angiogenesis that gradually restores the vascular supply to the wound bed. Over the course of a treatment program, the wound transitions from a stalled inflammatory state to an active proliferative state, enabling closure.

HBOT is an approved UHMS indication for problem wounds not adequately responding to standard care. It is particularly effective when used as part of a comprehensive wound care program that includes débridement, moisture management, infection control, offloading, and vascular assessment. At NorCal Hyperbarics, Dr. Toth collaborates with wound care specialists, vascular surgeons, and infectious disease physicians throughout the Bay Area to ensure each patient receives a fully integrated treatment plan. Typical wound care protocols involve 30 to 40 HBOT sessions, with progress evaluated at regular intervals.