Frequently Asked Questions

Hyperbaric oxygen therapy (HBOT) is an evidence-based medical treatment. You breathe pure oxygen (O2), either continuously or at intervals, inside a hyperbaric chamber (pressure chamber) where the pressure is higher than the normal atmospheric pressure around us.

By raising oxygen levels in the blood and tissues, this treatment achieves good results in many conditions.

• Decompression sickness (the bends)
• Carbon monoxide poisoning (for example from a faulty stove)
• Sudden hearing loss
• Sudden vision loss
• Gas gangrene
• Anoxic encephalopathy (brain injury caused by a lack of oxygen, for various reasons)
• Avascular necrosis (death of bone tissue)
• Bone infections
• Chronic (non-healing) wounds
• Diabetic foot infections
• Wounds caused by blocked blood vessels
• Burns
• Compromised skin grafts and flaps (tissue patches)
• Wounds caused by radiotherapy (radiation treatment)
• Crush and avulsion injuries from accidents

In addition to all these conditions, hyperbaric oxygen therapy is an effective treatment for wounds and tissue loss after cosmetic Botox and filler injections, surgery and hair transplant procedures.

The main effects of HBOT on the body work in two ways.

The first is a mechanical effect caused by the increase in pressure. The second comes from the rise in oxygen levels in the blood and tissues.

HBOT also reduces swelling (oedema) and increases the production of many substances involved in wound healing. It supports the cells that help defend the body and stops some bacteria from multiplying.

Sudden hearing loss (sudden sensorineural hearing loss) is hearing loss of 30 dB or more across at least three consecutive frequencies on an audiogram (hearing test), developing over less than three days.

The exact cause is not known. Possible causes that have been suggested include problems with the blood vessels and circulation, infections and immune system disorders.

Hyperbaric oxygen therapy (HBOT) is thought to improve hearing that has been damaged by ischaemia (reduced blood supply) by increasing oxygen in the inner ear. HBOT also aims to improve the metabolism of the inner ear by reducing inflammation and swelling (oedema) and suppressing autoimmune damage. The goal is to prevent permanent damage to the inner ear.

Good results have been shown in patients who start treatment within the first month after sudden hearing loss.

The earlier treatment starts, the better the chance of success.

The brain is one of the organs most sensitive to a lack of oxygen. When oxygen flow to the brain stops, brain damage develops within a short time. Anoxic encephalopathy can have many different underlying causes, including trauma, cardiac arrest, stroke, drowning and poisoning. In all of these, the brain's oxygen supply is disrupted.

Hyperbaric oxygen therapy increases the level of dissolved oxygen in brain tissue and reduces swelling of the brain (cerebral oedema). As a result, oxygen can reach the areas of the brain that have been starved of it.

These patients should start treatment as soon as possible, without interrupting their other treatments or intensive care needs.

Avascular necrosis (also called aseptic necrosis) is the death of bone tissue because its blood supply is insufficient, which can happen for a number of reasons.

It most often affects the head of the thigh bone (femur).

Less commonly, it can develop in other parts of the body, such as the arm, knee, wrist and foot.

Patients usually come to us with pain and restricted movement. Published studies show that hyperbaric oxygen therapy (HBOT), by improving oxygen supply, can halt the progression of the disease or lead to full recovery, particularly in patients diagnosed at an early stage.

After accidents and disasters such as road traffic accidents, trauma or earthquakes, crushing, compression and long periods of immobility can lead to swelling (oedema), impaired circulation and too little oxygen reaching the tissues. As a result, blood flow to the tissues falls.

When tissues and organs do not get enough blood and oxygen, the process can end in tissue death.

Hyperbaric oxygen therapy (HBOT) reduces swelling, raises oxygen levels and supports circulation. In this way it helps to prevent tissue damage and tissue death in these injuries.

Necrotising infections can develop after foreign bodies enter the tissue, after surgery or after trauma, and they can also appear spontaneously.

They are rare but life-threatening. Patients usually have an underlying condition such as cancer or diabetes, or a history of an illness or medication that suppresses the immune system.

What these infections have in common is that poor oxygen supply allows bacteria to multiply very quickly.

Early signs can include pain, swelling (oedema), a crackling feeling or sound when the skin is touched, and very foul-smelling discharge.

Given alongside medical and surgical treatment, hyperbaric oxygen therapy raises oxygen levels and creates an environment in which bacteria cannot grow well.

It also makes some antibiotics more effective and supports the body's immune functions.

Osteomyelitis is an infection of bone tissue that progresses and leads to bone death. It is divided into two types: acute and chronic. Chronic osteomyelitis usually develops after inadequate treatment and can continue for months or even years.

Treating chronic osteomyelitis needs a multidisciplinary approach. Alongside medication, wound care and surgery where needed, hyperbaric oxygen therapy (HBOT) can significantly improve the chance of success. HBOT increases oxygen in the bone tissue, speeds up wound healing and makes some antibiotics more effective.

As well as chronic osteomyelitis, HBOT is also used in some patients with acute osteomyelitis. Good results have been seen in healing of the bone and wound area in acute osteomyelitis of the spine, skull and breastbone (sternum).

Skin grafts and flaps, also known as skin patch operations, are among the most common surgical procedures used to treat problem wounds that will not heal.

In patients with poor circulation (especially people with diabetes and those with blocked blood vessels), these operations may have a lower chance of success.

Low oxygen levels reduce the chance that a graft or flap will take. By supporting circulation and increasing oxygen in the tissues, hyperbaric oxygen therapy can significantly improve the success of graft and flap operations.

It is used before surgery to improve blood supply to the area, and after surgery to help it heal faster.

Wounds that do not heal for a long time (chronic wounds) usually have an underlying cause that stops tissue from healing, such as diabetes, blocked blood vessels, poor circulation or radiation treatment. These conditions delay wound closure and lead to problem wounds that will not heal.

Healing a chronic wound needs several medical specialties working together. Alongside wound care, medication and surgery, improving blood supply to the wound and providing enough oxygen are important for healing.

Because of their underlying causes, chronic wounds usually have poor oxygen supply: they are hypoxic, meaning their oxygen levels are low. In this low-oxygen tissue, many types of infection-causing organisms can grow, especially anaerobic bacteria.

In treating chronic wounds, hyperbaric oxygen therapy aims first to raise oxygen levels and so speed up healing. As well as increasing oxygen in the wound tissue, HBOT makes some antibiotics more effective, supports the production of healthy collagen and boosts circulation to speed up the formation of new tissue.

We provide emergency treatment 24 hours a day, 7 days a week, working in coordination with the Provincial Health Directorate and the 112 emergency service. In conditions such as carbon monoxide poisoning, decompression sickness (the bends), gas embolism and sudden loss of hearing or vision, it is important to come to us as quickly as possible.

Decompression sickness (DCS), commonly known as the bends, is linked to diving. Nitrogen dissolved in the blood is not cleared properly during the ascent to the surface, and gas bubbles form in the blood vessels and body tissues. Depending on dive time, depth, ascent rate and some personal factors, it can cause mild symptoms or severe, life-threatening illness. Hyperbaric oxygen therapy is the main treatment for decompression sickness.

There are two types:

• Type 1 decompression sickness: a mild form with joint pain and skin symptoms.
• Type 2 decompression sickness: a more severe form. It affects the circulation, breathing and nervous system and can be fatal.

Gas embolism happens when air or another gas enters the circulation. Symptoms can be mild or severe, depending on the volume of gas and where the blockage forms. It can be linked to diving and, rarely, can also occur during surgical procedures. Asthma, COPD and some conditions that cause scarring (adhesions) in the lungs can increase the risk of gas embolism. Hyperbaric oxygen therapy is also the main treatment for gas embolism.

If decompression sickness and/or gas embolism is suspected, contact a specialist in underwater and hyperbaric medicine urgently. The patient should be transferred without delay, under suitable conditions, to the nearest centre with a hyperbaric chamber.

The most common side effect of hyperbaric oxygen therapy is barotrauma.

Barotrauma is caused by changes in pressure.

Middle ear barotrauma is the most common type, but it usually clears up quickly without leaving any damage.

Oxygen toxicity, temporary (reversible) short-sightedness (myopia) and pneumothorax (collapsed lung) are very rare side effects.

To keep the risk of side effects as low as possible, every patient is assessed with an examination and any necessary tests before treatment.

Thanks to close monitoring during sessions and a safe treatment environment, serious side effects are rare.

Carbon monoxide is a colourless, odourless, tasteless and poisonous gas. It binds to haemoglobin, the molecule in the blood that carries oxygen to the tissues, about 200 times more strongly than oxygen does. Poisoning usually comes from stoves and gas water heaters, smoke inhaled during a fire, or breathing in exhaust fumes.

When carbon monoxide binds to haemoglobin, the tissues cannot receive enough oxygen, and many different symptoms can appear. Depending on how long the person was exposed and the concentration of the gas, carbon monoxide poisoning can cause mild symptoms such as nausea, vomiting, tiredness, headache and dizziness. It can also lead to loss of consciousness, cardiac arrest and death.

Treatment is based on giving the patient oxygen to breathe. The outcome depends on how soon treatment starts and how the oxygen is given. Children, older people, pregnant women, people with certain chronic illnesses and people who have drunk alcohol are at higher risk.

Hyperbaric oxygen therapy quickly separates carbon monoxide from haemoglobin. It also allows a large amount of oxygen to dissolve in the blood, so the tissues receive enough oxygen. In severe poisoning and in high-risk patients, hyperbaric oxygen therapy is the main treatment.

In patients who have had radiotherapy, radiation necrosis can cause different symptoms, depending on the area treated, the radiation dose and the patient's own characteristics.

These unwanted side effects can appear soon after treatment or a long time later.

Radiotherapy damages the blood supply to the treated area, which reduces its nourishment and oxygen supply.

Because these areas are also less able to repair themselves, even very small injuries (microtrauma) can cause tissue damage.

Hyperbaric oxygen therapy helps to reverse the harmful effects of radiotherapy on different tissues, including the bowel, bladder, skin, brain tissue, genital organs and bone.

HBOT increases oxygen in the damaged tissue and supports the growth of new small blood vessels (capillaries).

A blockage in the retinal artery, the main blood vessel supplying the eye, or in one of its branches can cause sudden loss of vision.

This type of vision loss comes on suddenly and without pain.

Depending on how severe the blockage is and where it is, vision loss can be partial or total.

Some underlying conditions, such as diabetes, blocked blood vessels, high blood pressure (hypertension) and heart valve disease, can increase the risk of retinal artery occlusion.

Hyperbaric oxygen therapy raises oxygen levels in retinal tissue whose blood supply has been disrupted, helping to keep the retina alive and working.

Patients diagnosed by an ophthalmologist with sudden vision loss due to retinal artery occlusion should go to a centre with a hyperbaric chamber as soon as possible.

Burns are tissue damage caused by heat, the sun, electricity or exposure to various chemicals. Mild burns can be treated as an outpatient, but patients with severe burns may need to be admitted to hospital. Serious burns need a multidisciplinary approach.

The aims of treatment are to control swelling (oedema), prevent tissue loss by supplying enough oxygen, stop the damage from spreading, reduce the risk of infection, speed up wound healing and protect patients from organ failure.

Burn degrees are a classification that describes how serious a burn is:

• First-degree burn: this minor type of burn affects only the outer layer of the skin (epidermis). It can cause redness and pain.
• Second-degree burn: these burns affect both the epidermis and the second layer of skin (dermis). They can cause swelling and red, white or blotchy skin. Blisters may form and the pain can be severe. Deep second-degree burns can leave scars.
• Third-degree burn: there is a layer of fat beneath the skin. In this type of burn, the damage goes through the skin and reaches this fat layer. The skin takes on a leathery appearance. Third-degree burns can destroy nerves, causing loss of feeling or numbness in the area. They need urgent medical treatment.
• Fourth-degree burn: these burns reach as deep as the bones and joints. They need urgent medical treatment.

Hyperbaric oxygen therapy should be used for burns covering more than a certain percentage of the body surface, burns with carbon monoxide poisoning or major trauma, electrical burns, burns to the hands, face or perineum, burns affecting the airways, and burns in high-risk patients. HBOT aims to reduce swelling and, as a result, improve blood supply and oxygen to the tissue. Its anti-inflammatory effect helps to block the inflammatory cascade triggered by the burn and to stop the damage from progressing.

Frostbite is a cold (hypothermic) injury and a form of thermal injury. Severe narrowing of the blood vessels disrupts circulation. Tissue is damaged both by poor circulation and lack of oxygen, and during rewarming. Hyperbaric oxygen therapy is also an effective treatment for frostbite injuries.

Please call us to book an appointment before your first examination. This helps us plan your time and assess your treatment needs thoroughly.

Please bring any information and documents about previous illnesses, a list of the medicines you currently take (or your prescription), and any earlier scans or tests such as MRI, CT or X-rays.

After your first examination, if there is no reason you cannot have treatment, we plan your sessions on the most suitable days and times. We take into account your health, whether you will need a stretcher or wheelchair, how intensive your treatment will be and your quality of life.

Once your treatment plan is in place, it is important to stick to it. Please arrive at least half an hour before your session to register. If you need a dressing change, letting our healthcare staff know in advance helps things go more quickly.

Patients with a condition on the approved indication list and a doctor's report under SGK (Turkey's Social Security Institution) can be treated with SGK cover. We are contracted with SGK and also work with many private health insurance and complementary health insurance providers.