Hyperbaric Oxygen Therapy

To the Editor.— I was disturbed by the recent review on hyperbaric oxygen (HBO) therapy.1As the former director of several ongoing Air Force human clinical trials of HBO therapy for diabetic wound healing and chronic osteomyelitis, I believe that the article did not sufficiently emphasize the experimental nature of HBO therapy in wound healing. Further, I found that the review closely followed the advocacy style of the Undersea and Hyperbaric Medical Society,2even down to its inaccurate references (eg, the article by Van Unnik does not say that 250 mm Hg of oxygen tension alters Clostridial alpha toxin production; rather, he concludes that "the production of alpha toxin is inhibited during treatment with oxygen at a pressure of 3 atmospheres absolute but not at a pressure of 2 atmospheres"). The brief review on carbon monoxide poisoning is a further example of this advocacy bias: the only