For Physicians

Clinical Evidence Summary

  • Key trials, Cochrane reviews & guidelines
  • A quick reference for referring physicians

This page provides a concise evidence summary for each of the OHIP-covered indications and the off-label indications we offer. It is intended as a quick reference for physicians considering a referral. Full references are available on each individual indication page.

OHIP-Covered

OHIP-Covered Indications
— Key Evidence Sources

Chronic non-healing wounds and diabetic foot ulcers

  • Kranke P et al. Hyperbaric oxygen therapy for chronic wounds. Cochrane Database Syst Rev. 2015;(6):CD004123.
  • Stoekenbroek RM et al. Hyperbaric oxygen for the treatment of diabetic foot ulcers: a systematic review. Eur J Vasc Endovasc Surg. 2014;47(6):647-655.
  • Huang ET et al. Clinical practice guideline for HBOT in diabetic foot ulcers. Undersea Hyperb Med. 2015;42(3):205-247.

Late radiation tissue injury

  • Bennett MH et al. Hyperbaric oxygen therapy for late radiation tissue injury. Cochrane Database Syst Rev. 2016;(4):CD005005.
  • Marx RE et al. Prevention of osteoradionecrosis: randomized prospective clinical trial. J Am Dent Assoc. 1985;111(1):49-54.
  • Clarke RE et al. HBOT for chronic refractory radiation proctitis: randomized controlled trial. Int J Radiat Oncol Biol Phys. 2008;72(1):134-143.

Idiopathic sudden sensorineural hearing loss

  • Bennett MH et al. Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus. Cochrane Database Syst Rev. 2012;(10):CD004739.
  • Chandrasekhar SS et al. Clinical practice guideline: sudden hearing loss (update). Otolaryngol Head Neck Surg. 2019;161(1_suppl):S1-S45.
  • Rhee TM et al. HBOT plus medical therapy for ISSNHL: meta-analysis. JAMA Otolaryngol Head Neck Surg. 2018;144(12):1153-1161.

Chronic refractory osteomyelitis

  • Savvidou OD et al. HBOT for chronic osteomyelitis: systematic review. Orthopedics. 2018;41(4):193-199.

Compromised grafts and flaps

  • Friedman HI et al. Evidence-based appraisal of HBOT on flaps and grafts. Plast Reconstr Surg. 2006;117(7 Suppl):175S-190S.

Thermal burns

  • Cianci P et al. Adjunctive HBOT in thermal burns. Undersea Hyperb Med. 2013;40(1):89-108.
  • Villanueva E et al. HBOT for thermal burns. Cochrane Database Syst Rev. 2004;(2):CD004727.

Avascular necrosis (osteonecrosis)

  • Camporesi EM et al. Hyperbaric oxygen therapy in femoral head necrosis. J Arthroplasty. 2010;25(6 Suppl):118-123.
  • Reis ND et al. HBOT as a treatment for stage-I AVN of the femoral head. J Bone Joint Surg Br. 2003;85(3):371-375.
  • Bennett MH et al. HBOT for promoting fracture healing and treating fracture non-union. Cochrane Database Syst Rev. 2012;(11):CD004712.

Crohn’s disease (perianal fistulas)

  • Feitosa MR et al. Adjunctive HBOT for refractory Crohn’s disease. Acta Cir Bras. 2016;31 Suppl 1:19-23.
  • Lavy A et al. HBOT for perianal Crohn’s disease. J Clin Gastroenterol. 1994;19(3):202-205.
  • Dulai PS et al. HBOT for ulcerative colitis: phase 2A pilot RCT. Am J Gastroenterol. 2018;113(10):1516-1523.

Off-Label

Off-Label Indications —
Key Evidence Sources

Post-concussion syndrome and mild TBI

  • Boussi-Gross R et al. HBOT can improve post concussion syndrome years after mild TBI: randomized prospective trial. PLoS One. 2013;8(11):e79995.
  • Miller RS et al. HBOT and persistent postconcussion symptoms in service members: RCT. JAMA Intern Med. 2015;175(1):43-52.
  • Hadanny A et al. HBOT for chronic neurocognitive deficits of post-TBI patients. BMJ Open. 2018;8(9):e023387.

Long COVID

  • Zilberman-Itskovich S et al. HBOT improves neurocognitive functions and symptoms of post-COVID condition: RCT. Sci Rep. 2022;12(1):11252.

Inflammatory bowel disease

  • Dulai PS et al. HBOT for ulcerative colitis flares: phase 2A pilot multi-center RCT. Am J Gastroenterol. 2018;113(10):1516-1523.
  • Feitosa MR et al. Adjunctive HBOT for refractory Crohn’s disease. Acta Cir Bras. 2016;31 Suppl 1:19-23.

Orthopedic non-union

  • Bennett MH et al. HBOT for promoting fracture healing and treating fracture non-union. Cochrane Database Syst Rev. 2012;(11):CD004712.

Foundational references

  1. Moon RE (ed.). Hyperbaric Oxygen Therapy Indications. 14th ed. Best Publishing; 2019.
  2. Mathieu D, Marroni A, Kot J. Tenth European Consensus Conference on Hyperbaric Medicine. Diving Hyperb Med. 2017;47(1):24-32.
  3. Thom SR. Hyperbaric oxygen — its mechanisms and efficacy. Plast Reconstr Surg. 2011;127(Suppl 1):131S-141S.
  4. Heyboer M et al. Hyperbaric oxygen therapy: side effects defined and quantified. Adv Wound Care. 2017;6(6):210-224.
Medical review

Dr. Vik Agarwal MD CCFP FRCPC CAQ-HP — President, Evolve Medical Group

Dr. Seema Agarwal MD CCFP CAQ-HP — Chief Medical Officer, Evolve Hyperbarics

Last reviewed: May 2026 · Next: May 2027

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