Asia
Hyperbaric
Centre
Who Is
This For?
This supportive protocol is designed specifically for individuals managing Type 1 or Type 2 diabetes who have developed full-thickness lower extremity wounds. It is most appropriate for those whose wounds have not responded to standard wound care, or where tissue compromise has progressed to a stage where major intervention is being considered.
To qualify for this protocol, clients typically meet the following criteria:
Diagnosed with Type 1 or Type 2 diabetes.
Presenting with a lower extremity wound (foot, ankle, or lower leg) that has been graded as Wagner Grade III or higher — meaning the wound has penetrated deeply, involving tendon, joint capsule, or bone.
Having adequate large-vessel blood supply, or having recently undergone revascularisation to restore blood flow to the limb.
Timing is everything when it comes to limb preservation. The Undersea and Hyperbaric Medical Society (UHMS) [3] and major national healthcare frameworks [7] agree that hyperbaric oxygen is most effective when introduced as an adjunctive service after conventional care has plateaued.
You should consider introducing hyperbaric oxygen into your care plan if:
Your wound has shown no measurable signs of healing after 30 days of consistent, standard wound care (including off-loading, debridement, and infection control).
A vascular specialist has confirmed that while large-vessel flow is adequate, the micro-circulation around the wound itself remains severely hypoxic (deprived of oxygen).
Your care team is discussing the risk of major amputation, and you want to introduce an evidence-backed supportive protocol to reduce that risk.
When to Consider HBOT
Why HBOT Works for Diabetic Wounds
The fundamental obstacle in diabetic wound healing is hypoxia. Diabetes damages the micro-circulation, narrowing the tiny capillaries that carry oxygen-rich blood to the extremities. Without oxygen, cells cannot produce collagen, fight off bacteria, or build new blood vessels. The tissue essentially starves.
Normal breathing, even with pure oxygen, cannot solve this. The red blood cells are already saturated, and they cannot fit through damaged capillaries.
Inside our chamber, we change the physics. By delivering 99.5% medical-grade oxygen at pressures up to 3 ATA, we bypass the red blood cells entirely. Under pressure, oxygen dissolves directly into the blood plasma [3]. This oxygen-saturated plasma can diffuse into compromised tissue at a depth that normal circulation simply cannot reach — keeping cells alive, stimulating collagen synthesis, and triggering the growth of new micro-vessels (angiogenesis).
The Science & Clinical Evidence
We do not ask you to rely on marketing claims. The efficacy of hyperbaric oxygen as an adjunctive service for diabetic foot ulcers is documented across decades of peer-reviewed clinical research, including multiple randomized controlled trials and large-scale meta-analyses.
A comprehensive meta-analysis published in Nature Scientific Reports [1] analyzed data from 14 controlled clinical trials involving 768 participants. The researchers confirmed that adjunctive hyperbaric oxygen was significantly effective in achieving complete healing of diabetic foot ulcers (Odds Ratio = 0.29; 95% Confidence Interval 0.14–0.61) and led to a substantial reduction in the rate of major amputations.
Similarly, a systematic review in the Journal of Vascular Surgery [2] evaluating 729 patients found that introducing hyperbaric oxygen reduced the major amputation rate to 10.7% compared to 26.0% in the control group receiving standard care alone. This represents a 15% absolute risk reduction, meaning that for every 7 patients treated, one major amputation was prevented (Number Needed to Treat = 7).
10.7% amputation rate with adjunctive HBOT — vs 26.0% with standard care alone.— Brouwer et al., Journal of Vascular Surgery, 2020 [2]
OR: 0.29 — the odds of complete wound healing nearly tripled with adjunctive hyperbaric oxygen.— Sharma et al., Nature Scientific Reports, 2021 [1]
NNT = 7 — for every 7 clients who completed the protocol, one major amputation was prevented.— Brouwer et al., Journal of Vascular Surgery, 2020 [2]
Our protocols do not deviate from the standards established by the Undersea and Hyperbaric Medical Society (UHMS) [3] and validated by clinical practice guidelines [10]. This is not a "mild" wellness session — it is a precise, high-pressure protocol designed to achieve the oxygen tissue saturation levels documented in clinical research.
Oxygen Purity: 99.5% Medical-Grade Oxygen — pharmaceutical purity under Cap. 138 [5].
Chamber Pressure: 2.0 to 2.4 ATA (Atmospheres Absolute) — the pressure range required to dissolve oxygen into plasma [3].
Session Duration: 90 minutes at depth — the standard window for cellular activation.Frequency: Once daily, 5 days per week — continuous stimulation of micro-vessel growth.
Total Course: 20 to 40 sessions (typically 30) — full tissue remodeling and wound closure support.
The Protocol
What To Expect
We understand that entering a hyperbaric chamber can feel unfamiliar. Our team is here to guide you through every step of the process, ensuring you feel comfortable, safe, and supported.
Step 1 — The Briefing & Preparation: Before your first session, our technician will walk you through the safety protocols. You will change into 100% cotton clothing (provided) to eliminate static risk. No electronics, watches, or oil-based cosmetics are allowed inside the chamber.
Step 2 — Pressurisation: As the chamber pressurises over 10-15 minutes, you will feel a sensation in your ears similar to descending in an airplane. Our technician will coach you on simple techniques to clear your ears. Once at depth (2.0-2.4 ATA), you will breathe 99.5% pure oxygen through a comfortable hood or mask. You can read, rest, or watch a screen during the 90-minute session.
Step 3 — Depressurisation & Next Steps: The chamber will slowly depressurise over 10-15 minutes. Once open, you can return to your normal daily activities immediately. Our technician will examine your wound site and coordinate with your primary wound care team to track your progress.
FAQ
How many sessions before I notice a difference?
Most protocols run 20 to 40 sessions. Some clients report improved wound appearance within the first 5–10 sessions, though this varies significantly from person to person. The full course is necessary for complete tissue remodelling and sustained closure. Your referring doctor and our team will monitor progress together throughout.
Is the session uncomfortable?
The only physical sensation you will feel is the pressure change in your ears during the first and last 15 minutes, which is easily managed. The chamber is spacious, well-lit, and climate-controlled. A technician is stationed directly outside the window throughout your entire session, communicating with you via intercom.
How do we know if the protocol is working?
We monitor your wound progress closely. In alignment with international standards [7] [8], we look for measurable signs of healing — such as wound shrinkage, healthier tissue bed color, and reduced discharge — within every 20-session block.
Sharma R, Sharma SK, Mudgal SK, et al. Efficacy of hyperbaric oxygen therapy for diabetic foot ulcer, a systematic review and meta-analysis of controlled clinical trials. Scientific Reports. 2021;11:2189.
Brouwer RJ, Lalieu RC, Hoencamp R, et al. A systematic review and meta-analysis of hyperbaric oxygen therapy for diabetic foot ulcers with arterial insufficiency. Journal of Vascular Surgery. 2020;71(2):682-692.
Undersea and Hyperbaric Medical Society. Indications for Hyperbaric Oxygen Therapy: Diabetic Wounds. UHMS Featured Resources.
Zhang Z, et al. Efficacy of hyperbaric oxygen therapy for diabetic foot ulcers. Chinese Journal of Traumatology. 2022.
Hong Kong e-Legislation. Pharmacy and Poisons Ordinance (Cap. 138). HKSAR Government.
Kranke P, Bennett MH, Martyn-St James M, et al. Hyperbaric oxygen therapy for chronic wounds. Cochrane Database of Systematic Reviews. 2015.
Centers for Medicare & Medicaid Services. National Coverage Determination for Hyperbaric Oxygen Therapy (20.29). CMS.gov.
Noridian Healthcare Solutions. Hyperbaric Oxygen (HBO) Therapy Coverage Guidelines. Noridian Medicare.
Damineni U, et al. Clinical Outcomes of Hyperbaric Oxygen Therapy for Diabetic Foot Ulcers: A Systematic Review. Cureus. 2025;17(1).
Huang ET, et al. A clinical practice guideline for the use of hyperbaric oxygen therapy in the treatment of diabetic foot ulcers. Undersea and Hyperbaric Medicine. 2015;42(3):205-216.
