Historical perspective Literature on the use of HBOT initially emerged in the 1930s (1). During this decade, universities and navies across the globe began to experiment with using oxygen at elevated pressure to treat arterial gas embolism and decompression sickness (1). The first publication describing the use of HBOT to treat decompression sickness was published in 1937 in the United States Naval Medical Bulletin (3). By the 1940s, HBOT had been incorporated into standard treatment tables of

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... he United States Navy (1). In 1960, Ite Boerema was the first to utilize HBOT for the treatment of gas gangrene (1). Current indications for the use of HBOT According to the Undersea and Hyperbaric Medical Society, HBOT is approved for the treatment of 14 disease states. These include air or gas embolism, clostridial myositis and myonecrosis (gas gangrene), carbon monoxide poisoning, compartment syndrome, crush injury, and other acute traumatic ischemias, necrotizing soft tissue infections (NSTIs), decompression sickness, arterial insufficiencies, intracranial abscess, severe anemia, refractory osteomyelitis, compromised grafts and flaps, delayed radiation injury (soft tissue and bony necrosis), acute thermal burn injury, and idiopathic sudden sensorineural hearing loss (1). Of these 14 conditions, NSTIs and compromised grafts and flaps are the most relevant to dermatology. However, HBOT has been used "offlabel" for the treatment of several other dermatological diseases.