Hyperbaric Oxygen Therapy for Pressure Sores: What to Expect
Table of Contents
What Hyperbaric Oxygen Therapy Actually Involves
What an HBOT Treatment Course Can Involve
What the Evidence Says About Hyperbaric Oxygen Therapy for Pressure Sores
HBOT Treatment Duration: How Many Sessions and Over What Period
HBOT Does Not Replace Pressure Ulcer Offloading Techniques
Risks, Side Effects and Who Needs Careful Assessment Before HBOT
Availability on the NHS and What a Wound Care Specialist Consultation Should Cover
Conclusion: Questions I Would Ask Now
Frequently Asked Questions
Last Updated: September 23, 2026
What Hyperbaric Oxygen Therapy Actually Involves
Hyperbaric oxygen therapy is a treatment where you breathe pure oxygen inside a sealed chamber at higher-than-normal pressure. The raised pressure lets your blood carry far more oxygen than it normally would. (Source: some studies suggest HBOT may help certain hard-to-heal wounds when added to good wound care)
I'm not a doctor. I'm the patient. This article combines published information with lessons from my own experience of living with serious pressure sores. It is intended to help you understand the subject and ask better questions of your healthcare team, not replace professional medical advice.
At Pressure Sore Recovery, I write about this from the patient's chair, not the consultant's desk. Hyperbaric oxygen therapy for pressure sores is usually an add-on, never a stand-alone fix.
What an HBOT Treatment Course Can Involve
There's no universally established HBOT protocol for pressure sores. What a course involves - the pressure used, how long you spend in the chamber, and the overall plan - varies by condition, by patient, and by the specialist team running it. As a general guide, sessions typically run 60 to 120 minutes: you lie or sit inside a clear chamber while the pressure rises, and staff stay with you throughout.
Most people wear a hood or mask to breathe the oxygen. You can usually watch TV, listen to music or sleep. Some units give you a short break partway through.
The pressure change makes your ears feel like they do on a plane. Yawning and swallowing help. Tell staff straight away if you feel pain or panic.
What the Evidence Says About Hyperbaric Oxygen Therapy for Pressure Sores
The evidence for hyperbaric oxygen therapy is not the same across all chronic wounds. HBOT is much better studied for conditions like diabetic foot ulcers, where trials support its use as an adjunct in some cases. For pressure sores specifically, the evidence is far more limited, and HBOT is not an established or proven treatment.
A Cochrane review looking specifically at pressure ulcers found no evidence from eligible trials to confirm or refute whether HBOT has any effect on healing. That's not the same as proof it doesn't work - it means the trials needed to answer the question reliably don't yet exist. Guidelines generally treat HBOT, where used at all for pressure sores, as a possible adjunct in selected cases, not routine care.
That word "adjunct" matters. It means HBOT sits alongside proper offloading, wound care, infection control and nutrition. It never replaces them.
Watch Out HBOT is not a substitute for pressure relief. If pressure and shear continue, no amount of oxygen in a chamber will heal the wound underneath.
HBOT Treatment Duration: How Many Sessions and Over What Period
There is no universally established HBOT protocol for pressure sores. Where a specialist team does offer a course, planning typically depends on things like the reason for considering HBOT, the pressure and oxygen exposure used, and how often sessions are given. Numbers you may see elsewhere - such as courses of 20 to 40 daily sessions, five days a week - come from other recognised HBOT indications like diabetic foot ulcers, not from an established pressure-sore recommendation.
What matters more than a fixed number of sessions is ongoing monitoring. A specialist team should track how your wound responds and reassess at agreed points, adjusting or stopping the course if it isn't improving.
The decision to continue should rest on measurable change, not on finishing a set number. Ask what "progress" looks like for your wound.
HBOT Does Not Replace Pressure Ulcer Offloading Techniques
Pressure ulcer offloading techniques remain the foundation of healing. Offloading means removing or spreading the pressure that caused the sore in the first place.
For most people that means:
Repositioning on a set schedule, day and night
A pressure-redistributing mattress or cushion
Keeping the wound off weight-bearing areas entirely
Managing shear, the dragging force when you slide or transfer
Shear is the one people forget. It damages tissue even when pressure looks fine on paper.
If you are in a chamber every morning but sitting on the same sore every afternoon, you are undoing the treatment. Offloading comes first. Everything else supports it.
Risks, Side Effects and Who Needs Careful Assessment Before HBOT
Most side effects are mild and short-lived. Ear pressure and discomfort are the most common. Some people get sinus pain, tiredness or temporary changes in eyesight.
The principal absolute contraindication is an untreated pneumothorax (collapsed lung), because the pressure changes inside the chamber can make this worse. More serious risks are otherwise uncommon but real, and can include seizures from too much oxygen. Units screen for these before starting.
Beyond that, these do not rule HBOT out on their own, but need individual specialist assessment rather than a simple checklist:
Certain heart or lung conditions
Difficulty equalising ear or sinus pressure
Seizure disorders
A high fever or active untreated infection
Certain medications or implants
Severe claustrophobia
Tell the team about every condition and medication. Never hide a diagnosis to get accepted onto a course.
Availability on the NHS and What a Wound Care Specialist Consultation Should Cover
Availability on the NHS varies. Hyperbaric oxygen therapy is not offered everywhere, and pressure sores are not its only use. Some units prioritise other conditions.
Access usually comes through a referral, not a self-referral. Your wound care specialist or consultant makes the case.
A good wound care specialist consultation should cover:
Whether your wound is actually failing to heal, and why
Whether offloading, infection and nutrition have been properly addressed first
Whether HBOT is likely to help your specific wound
What the realistic aims and stopping points are
What the alternatives are if HBOT is not available
Ask directly: "What would make you stop this treatment?" If nobody can answer, that is worth pushing on.
Pro Tip Write your questions down before the appointment. In my experience, consultations move fast and it is easy to leave without asking the thing you actually wanted to know.
Conclusion: Questions I Would Ask Now
The honest position is this: hyperbaric oxygen therapy for pressure sores is a possible extra tool, not a guaranteed answer. The evidence is limited, access varies, and it only makes sense on top of proper offloading and wound care.
If you want to understand pressure, shear, infection and recovery in plain language, the 24-chapter guide Pressure Sore Recovery: What Nobody Told Me covers what I wish somebody had explained to me at the start. You can still use everything without it.
Frequently Asked Questions
Is hyperbaric oxygen therapy effective for pressure ulcers?
The evidence is mixed rather than settled. Some studies suggest HBOT may help certain chronic wounds, including pressure injuries, heal when standard care alone has stalled, but it is not a guaranteed treatment and results vary. It is best understood as an adjunct, used alongside offloading, wound care and good nutrition, not instead of them. Whether it helps your wound depends on its depth, location, infection status, circulation and underlying conditions, so the decision belongs with your wound-care team.
How many HBOT sessions are usually needed, and how long does each one last?
HBOT treatment duration varies. A common approach is one session a day, five or six days a week, for several weeks, with each session lasting roughly 90 to 120 minutes inside the chamber. Some protocols run longer. Your team should review the wound regularly and stop if there is no measurable progress. Ask upfront how many sessions are planned, what counts as progress, and at what point the course would be reconsidered rather than continued indefinitely.
Can HBOT replace pressure ulcer offloading techniques?
No. HBOT cannot compensate for continued pressure or shear. Pressure ulcer offloading techniques, such as repositioning schedules, appropriate support surfaces and equipment that redistributes load, remain the foundation of healing. If pressure and shear are not managed, extra oxygen delivered to the tissue will not overcome the damage being done. HBOT sits on top of good offloading, wound care, infection management and nutrition, never in place of any of them.
Is hyperbaric oxygen therapy available on the NHS for pressure sores?
Availability varies by region and is not uniform across the UK. Some NHS trusts have hyperbaric facilities, often linked to diving medicine or specialist wound services, and access usually depends on an individual clinical assessment and local referral criteria. Ask your wound care specialist whether HBOT is relevant to your wound, whether your local service offers it, and how referral works. If it is not available locally, your team can explain the alternatives.
Deciding whether to push for HBOT is hard when you are exhausted and the wound is not closing. Pressure Sore Recovery exists to help you ask sharper questions and take an active part in your own care, alongside your team. The guide walks through offloading, nutrition, infection and surgery recovery in practical terms. Get started with Pressure Sore Recovery and go into your next appointment better prepared.
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