Hyperbaric Oxygen Therapy for Difficult Wounds

The Research Question:

"What does the scientific literature tell us about the clinical and economic effectiveness of hyperbaric oxygen treatment for problem wound healing (i.e., diabetic and non-diabetic pressure ulcers, delayed radiation-induced injury, thermal burns, skin grafts and flaps, and post-organ transplantation revascularization), considering the expected patient populations and given the social, geographic, economic and political contexts of Newfoundland & Labrador?"

The original report on this topic was published in 2012. CHRSP returned to this topic in 2019 to find out whether there was new evidence.  Readers are encouraged to review the 2019 udate below for the latest health evidence. 


In 2008, responsibility for the Hyperbaric Oxygen Treatment (HBOT) facilities was transferred from Memorial University’s Centre for Offshore and Remote Medicine (MEDICOR) to the Eastern Health Regional Health Authority. The transfer of services reflects an ongoing shift in the uses of HBOT from mainly being used as an emergency treatment and research tool toward being used for adjuvant treatments for non-emergent conditions.

Subsequently, Eastern Health partnered with the Contextualized Health Research Synthesis Program to investigate what the scientific literature tells us about the evidence for the clinical and cost effectiveness of adjuvant HBOT for problem wounds.

In the context of this project, problem wounds include diabetic and non-diabetic pressure ulcers, delayed radiation-induced injury, thermal burns, skin grafts and flaps, and post-organ transplantation revascularization.

For this project, CHRSP has partnered with the Canadian Agency for Drugs and Technology in Health (CADTH) to identify and synthesize the recent high-level research literature, including systematic reviews, meta-analyses and health technology assessments. The synthesis also includes any high quality primary research that had been conducted recently enough so as not to have been captured by the review literature.

The CHRSP Project Team:

  • Pablo Navarro, CHRSP Project Coordinator
  • Norma Baker, COO, Adult Acute Care for Eastern Health (now retired),
  • Dr. Stephen Bornstein, CHRSP Program Director
  • Cathy Burke, Regional Director, Cardiac/Critical Care Program, Eastern Health
  • Mary Bursey, Associate Professor, School of Nursing, Memorial University
  • Dr. Ken LeDez, Chair of the Discipline of Anesthesia, Memorial University Faculty of Medicine and Director of MEDICOR

External Reviewer:

  • Dr. A Wayne Evans, Assistant Professor, Department of Anaesthesia, Faculty of Medicine, University of Toronto

Canadian Agency for Drugs and Technologies in Health (CADTH) Team:

  • Rhonda Boudreau, Research Officer, CADTH
  • Sarah McGill, Information Specialist, CADTH

Project Consultants:

  • Margo Cashin, Woundcare Consultant, Acute Care, Eastern Health
  • Elaine Carew, Patient Care Coordinator, Hyperbaric Medical Services, Eastern Health
  • Dr. Carla Wells, Woundcare Specialist and Research Coordinator, Western Health School of Nursing
  • Theresa Dyson, Regional Director of Community Health, Labrador-Grenfell Health