Pyoderma Gangrenosum

Pyoderma Gangrenosum (PG) has become known as the great marauder  because it is often mistaken for more common ulcerative wounds, such as arterial insufficiency wounds or necrotizing wounds, both of which are Undersea and Hyperbaric Medical Society (UHMS) approved indications for hyperbaric oxygen therapy (HBOT.) Although there have been case reports of successful treatment of PG wounds with HBOT since 1974, there have not been any large randomized and controlled research studies to support this observed effect and therefore, the treatment is not recommended for reimbursement by the UHMS. The condition is believed to be caused by an autoimmune attack, that once ulcerates, is susceptible to infection. The condition is rare, affecting 1 in 100,000 people, mostly in their middle years.

The research studies below discuss cases of varying severity, using a variety of treatments in combination with HBOT. The most serious of them include skin grafting, which is also a UHMS approved condition for HBOT. The typical treatment protocol used in these studies is the same that is used when treating other wounds or ulcerations of the skin. A pressure of 2.5 ATA (50 fsw) is used for 90-minutes, once a day until wound closure. Some wounds were closed with as little as 15 treatments, while others including skin grafting over large sections of the body, required over 80 treatments.

Scientific Resources