Hyperbaric Oxygen Therapy: Mechanisms, Clinical Applications, and Future Directions

Objective: To synthesize recent evidence (2020-2025) regarding Hyperbaric Oxygen Therapy (HBOT) mechanisms, effectiveness, safety, and new applications. Methods: A systematic literature review was conducted (PubMed, Scopus, Web of Science, Cochrane) using the terms "hyperbaric oxygen therapy" and primary indications (e.g., diabetic foot ulcer, radiation injury), mechanisms (e.g., angiogenesis), and safety. Boolean operators were used to limit searches. Peer-reviewed literature (2020-2025) adhering to inclusion criteria was title/abstract screened, reviewed at full text, and data extracted. Narrative synthesis appraised findings. Results: HBOT significantly improves diabetic foot ulcer healing (2.2 fold faster healing, 33-52% reduction in amputation risk) and radiation tissue injury (80% healing in osteoradionecrosis). HBOT reduces mortality in acute illnesses (e.g., 66% to 23% in Fournier's gangrene) and long-term sequelae in CO poisoning (50% reduction). Promising data are available for efficacy in post-stroke recovery, post-COVID cognitive dysfunction, Parkinson's, male infertility, and early femoral head necrosis. Side effects are rare (<5%) and typically minor (e.g., ear barotrauma). Conclusions: HBOT is effective and safe for established indications such as radiation injury and chronic wounds. New applications in oncology and neurology are promising but require further verification. The future of research is optimization and availability.