Non-Healing Wounds

The general criteria are a Wagner Grade 3 or higher ulcer (deep, with infection, bone involvement, or gangrene) that has not adequately healed after at least 30 days of good standard wound care. A transcutaneous oximetry (TCOM) test then confirms the wound area is oxygen-deprived and likely to respond. Contact us and we will review your situation with your wound-care provider.

Insurers generally expect a Wagner Grade 3 or higher ulcer documented by your wound-care provider, at least 30 days of standard wound care without adequate healing, documented blood-sugar management, a vascular evaluation with revascularization first where indicated, and transcutaneous oximetry (TCOM) showing low oxygen around the wound that improves under oxygen challenge. Our team helps assemble this documentation with your existing providers — it is usually already in your chart.

At participating MD Hyperbaric centers, yes — we are in-network providers and accept insurance, including Medicare, for qualifying diabetic foot ulcers, compromised skin grafts and flaps, and other selected problem wounds. Contact our center directly, or ask your podiatrist, wound-care specialist, or surgeon to send a referral. We verify your benefits before treatment begins. Coverage depends on your diagnosis, your plan, and medical-necessity criteria; most plans require prior authorization, which we coordinate with your physician and insurer using the wound documentation payers expect. Acute graft or flap cases are expedited because timing is critical. We will explain your expected costs before your first session.

Randomized studies of severe diabetic foot ulcers found that adjunctive HBOT reduced major amputation rates (Faglia et al, Diabetes Care 1996, PMID 8941460) and improved healing of chronic ulcers (Löndahl et al, Diabetes Care 2010, PMID 20427683). Careful patient selection matters: broader trials reported smaller or no effects (Margolis 2013, PMID 23423696; Fedorko 2016, PMID 26740639), which is why candidates are selected by wound grade and transcutaneous oximetry (Fife et al, PMID 19341127). For compromised grafts and flaps, clinical reviews and the UHMS Indications Manual support improved survival and reduced revision surgery when HBOT starts promptly (Friedman et al, PMID 16799386; Francis & Baynosa, PMID 28116225).

No — HBOT is an adjunct. You continue debridement, offloading, dressings, and infection management with your existing team while HBOT addresses the oxygen deficit that is holding healing back. Our Medical Director coordinates directly with your providers.

Immediately — call us the same day. Salvage results are markedly better when HBOT begins within 24–72 hours of the first signs of compromise, typically with twice-daily sessions for the first few days. We expedite evaluation and insurance authorization for these cases.