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.
Heat injuries that damage skin and deeper tissues, sometimes causing swelling, infection and circulation problems.
Poor arterial blood flow can cause hard-to-heal wounds or sudden loss of retinal circulation.
A rare condition in which small blood vessels calcify and clot, causing painful skin wounds and tissue damage.
Skin grafts or tissue flaps at risk of failure because of inadequate blood flow and oxygen delivery.
Severe trauma can damage muscle and circulation, causing swelling, tissue injury and compartment syndrome.
An autoimmune condition in which the pancreas produces little or no insulin, requiring lifelong insulin therapy.
A rapidly spreading bacterial infection that destroys muscle and soft tissue and requires emergency care.
Chronic inflammatory bowel diseases that can cause abdominal pain, diarrhea, bleeding and fatigue.
A rare blood-vessel disorder causing painful leg ulcers, skin discoloration and characteristic scarring.
An immune-mediated disease of the brain and spinal cord that can affect movement, sensation, vision and energy.
Rapidly spreading infections that destroy skin, fascia and other soft tissues and require emergency care.
Skin and tissue injuries caused by prolonged pressure or shear, especially in people with limited mobility.
A chronic immune-mediated skin condition causing inflamed, scaly plaques that may flare and remit.
A rare inflammatory skin disorder causing rapidly developing, painful ulcers, often on the legs.
Connective-tissue and vascular disorders that can affect skin, circulation, joints and internal organs.
Reactivation of the chickenpox virus causing a painful blistering rash and sometimes persistent nerve pain.
Severe reactions that cause widespread blistering, skin loss and injury to mucous membranes.
Chronic leg wounds caused by poor venous circulation, often with swelling and surrounding skin changes.
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