Hyperbaric Oxygen and Sickle Cell Leg Ulcers

By Rubicon Foundation editorial team

5 min read · 1 November 2026

Hyperbaric oxygen research in sickle cell leg ulcers examines whether breathing oxygen under increased pressure can support wound repair in a disease that disrupts blood flow and oxygen delivery. The question connects wound care with the physiology of hypoxia, while reminding divers that pressure-based treatment is not a routine remedy for every oxygen-related problem.

Why can sickle cell disease cause leg ulcers?

In sickle cell disease, haemoglobin can polymerise when oxygen levels fall, causing red blood cells to become rigid and distort their shape. These cells can obstruct small vessels, impairing local blood flow and contributing to tissue injury. Leg ulcers are one possible chronic complication.

A wound needs adequate perfusion—the movement of blood through tissue—to receive oxygen, nutrients and cells involved in repair. When circulation is compromised, a wound may persist despite ordinary care. The underlying disease matters: supplying more oxygen is not the same as correcting the vascular problem that limits its delivery.

What does hyperbaric oxygen change?

Hyperbaric oxygen therapy (HBOT) involves breathing oxygen in a pressurised chamber. Raising the pressure increases the amount of oxygen dissolved in plasma, the liquid component of blood. This can increase oxygen availability in tissues reached by the circulation, even though it does not make obstructed vessels disappear.

That distinction shapes the research question. Studies in this area examine whether the temporary increase in tissue oxygen can contribute to wound healing, and how any effect relates to blood flow, wound care and the person’s underlying sickle cell disease. A biological rationale is not, on its own, proof of clinical benefit.

What questions do studies of this kind examine?

Research on HBOT and chronic wounds has to consider both the treatment and the outcome. A wound’s size, depth, duration and healing trajectory may matter, as can concurrent care and changes in the disease affecting circulation. Researchers also need to consider whether an observed change is durable and clinically meaningful.

Oxygen delivery: can oxygen reach the affected tissue when small-vessel blood flow is impaired?
Healing: how does a wound change during treatment and follow-up?
Safety: what treatment risks or burdens matter for the individual receiving chamber therapy?
Context: how do standard wound care and sickle cell management shape interpretation?

These questions make comparison difficult: a wound may change over time for reasons beyond chamber exposure, and a treatment response in one setting cannot automatically be generalised to another. The clinical question is whether HBOT adds a useful role to comprehensive care, not simply whether oxygen levels can be raised.

Why is this relevant to diving and hyperbaric medicine?

HBOT and diving both involve pressure, but they are not interchangeable. In a therapeutic chamber, pressure is used to deliver a prescribed treatment; during a dive, pressure changes with depth and gas exposure, and decompression adds its own physiological demands. The shared environment makes pressure medicine relevant to divers, not the treatments themselves equivalent.

For diving physicians and scientific divers, this research area highlights the difference between oxygen availability and oxygen delivery. A diver with sickle cell disease or a chronic wound needs an individual assessment of health, circulation, medication and the planned exposure. Decisions about diving should involve a physician experienced in diving medicine; chamber treatment should be managed by clinicians familiar with hyperbaric medicine.

What risks and limits need attention?

HBOT has recognised risks, including pressure-related injury to the ears or sinuses, temporary visual changes and oxygen toxicity, which can affect the lungs or cause seizures. The likelihood and significance depend on the treatment protocol and the patient. Chamber care therefore requires clinical screening and monitoring rather than an assumption that more oxygen is always better.

Sickle cell disease also requires attention to the possibility that changes in oxygenation, circulation or illness may affect the individual in ways that a general account cannot predict. Treatment suitability belongs in a specialist clinical assessment. For a diver, the separate question of fitness to dive should be discussed with a diving-medicine physician.

Frequently asked questions

Is hyperbaric oxygen therapy a cure for sickle cell disease?

No. HBOT raises oxygen availability during treatment; it does not correct the inherited haemoglobin disorder or remove the cause of impaired blood flow.

Is chamber treatment the same as breathing oxygen while diving?

No. Therapeutic HBOT is delivered in a controlled clinical setting under a treatment protocol. Diving involves changing ambient pressure, breathing-gas exposure and decompression considerations.

Can someone with a leg ulcer and sickle cell disease dive?

That depends on the person’s health, wound, circulation, treatment and planned dive. A diving-medicine physician should assess fitness to dive; this general explanation cannot determine an individual’s suitability.

An original research-library explainer written by the Rubicon editors. It is not a summary of a specific publication.