Hyperbaric Oxygen Therapy in Burn Care: A Systematic Review of Current Evidence

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: Not quantified due to study heterogeneity

• Primary Outcome: Mixed results across healing, surgical needs, and hospital stay outcomes

• Nnt Or Sensitivity: Cannot be calculated from available data

• Confidence Interval: Not reported

Clinical Application

Limited by HBOT facility availability and cost considerations Relevant to major Australian burn centers with HBOT facilities; would require TGA consideration for formal indication and potential PBS listing for broader access Burn patients with acute injuries and threatened grafts in specialized burn centers

Abstract

Hyperbaric oxygen therapy (HBOT) involves inhaling 100% oxygen at pressures exceeding one atmosphere within a chamber. It is used across several specialties and has been proposed as an adjunct in burn management to enhance healing and improve outcomes. Despite increasing interest, evidence supporting its efficacy in burn care remains inconsistent, with no clear consensus in practice. A literature search was conducted in September 2025 across PubMed, Cochrane Library, and Embase without date restrictions to identify studies evaluating HBOT for burn treatment. Inclusion criteria were human studies, English-language articles, and full-text availability. Study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers screened titles and abstracts, and a third resolved discrepancies. Eligible studies described HBOT as a burn treatment and reported clinical outcomes. Thirteen studies met inclusion criteria: 5 randomized controlled trials, 7 cohort studies, and 1 case-control study, evaluating 566 burn patients. Burn severity, HBOT protocols, and outcomes varied substantially. Several studies reported reduced need for surgery and shorter hospital stays with HBOT. Trends toward improved healing and lower infection risk were noted, while mortality benefits were inconsistent. Heterogeneity in design and treatment regimens limited synthesis via meta-analysis. Hyperbaric oxygen therapy shows promise as an adjunct in burn care, improving healing and reducing complications. However, variability and inconsistent outcomes limit definitive conclusions. Well-designed randomized trials are needed to establish standardized protocols and clarify their clinical role in burn management. Until then, burn centers may consider HBOT for acute injuries and threatened grafts.

References

1. 1.Molina-Vega, J., Pferdehirt, R. E., & Vardanian, A. J. (2026). Hyperbaric oxygen therapy in burn care: A systematic review of current evidence. Journal of Burn Care & Research, Article irag026. https://doi.org/10.1093/jbcr/irag026