What is Hill Country Wound Care And Hyperbarics?

Specialized treatment for chronic, acute, and hard-to-heal wounds in San Antonio, including advanced hyperbaric oxygen therapy to accelerate healing.

What is osteomyelitis and how does it develop?

Osteomyelitis is a serious bacterial (or occasionally fungal) infection of the bone. It develops when bacteria reach bone through a nearby open wound (contiguous spread — the most common route in wound care patients), through the bloodstream (hematogenous), or as a complication of surgery or implants. In wound care patients, diabetic foot ulcers, pressure injuries, and chronic leg wounds that 'probe to bone' are the most frequent sources.

How do I know if my wound has osteomyelitis?

Clinical signs include deep bone pain disproportionate to the wound, fever, a wound that probes to bone, foul drainage that won't resolve with antibiotics, a draining sinus tract, or a wound over a bony prominence that simply will not heal. MRI is the most sensitive imaging test for confirming osteomyelitis. Bone biopsy with culture remains the gold standard for identifying the specific organism and guiding antibiotic selection.

Can osteomyelitis be treated without surgery?

In some cases — particularly early or superficial infections — prolonged antibiotic therapy alone may be sufficient. However, most cases of chronic osteomyelitis require surgical debridement to remove infected or necrotic bone before antibiotics can fully work. Our team evaluates each patient individually and coordinates with surgeons when intervention is needed.

How does hyperbaric oxygen therapy help with osteomyelitis?

HBOT may help chronic refractory osteomyelitis by increasing oxygen delivery to infected bone. This can support white blood cell activity, help certain antibiotics work more effectively, support new blood vessel growth, and assist the body's healing process. HBOT is typically used alongside antibiotics, wound care, and surgical management when needed.

How long does osteomyelitis treatment take?

Antibiotic therapy typically lasts 4–6 weeks for acute infections, and longer for chronic cases. Wound healing after surgical debridement may take additional weeks to months depending on the defect size and the patient's overall health. HBOT protocols for osteomyelitis typically involve 30–40 sessions. Our team monitors your progress at every visit and adjusts the plan as needed.

Does insurance cover osteomyelitis wound care and HBOT?

Yes — Medicare and most major insurance plans cover medically necessary wound care and HBOT for refractory osteomyelitis. Our care coordinators handle benefit verification and prior authorizations before treatment begins so you have no financial surprises.

Condition We Treat · San Antonio

OsteomyelitisBone InfectionTreatment San Antonio

Osteomyelitis is a serious bone infection that may develop from a chronic wound, diabetic foot ulcer, surgery, trauma, or another source of infection. At Hill Country Wound Care & Hyperbarics, our physician-led team helps evaluate suspected bone infections, coordinate diagnostic testing and antibiotic care, support wound healing, and provide adjunctive HBOT for chronic refractory osteomyelitis when medically appropriate.

HBOT-Certified PhysiciansMedicare AcceptedInfectious Disease CoordinationSeen Within 48 Hours

~20%

of diabetic foot ulcers that probe to bone will have confirmed osteomyelitis

Up to 6 weeks

minimum antibiotic duration — longer for chronic or recurrent infections

↑85%

Reported remission in refractory lower-extremity osteomyelitis when HBOT is combined with surgery and antibiotics

Physician Referrals

Refer a patient with osteomyelitis

Why It Matters

Osteomyelitis Is Serious.It Requires Specialist Care.

Osteomyelitis develops when bacteria from a chronic wound reach underlying bone — where poor blood supply and an absent immune response allow infection to take hold and persist despite standard antibiotic courses.

Once bone is infected, the wound above it cannot close. Without removing infected bone, controlling the organism with prolonged targeted antibiotics, and restoring oxygen to avascular tissue with HBOT, osteomyelitis almost always recurs — and amputation risk climbs significantly with each recurrence.

Warning Signs

Don't wait — seek specialist care

Deep bone pain or tenderness that is out of proportion to the visible wound

Persistent fever, chills, or fatigue alongside a non-healing wound

A wound that probes to bone or has visible bone at its base

Foul-smelling drainage that won't resolve despite antibiotic treatment

A draining sinus tract — a tunnel through skin that keeps reopening

A wound that is deep, worsening, exposes bone, or is not improving as expected

Your Healing Plan

Your Personalized Osteomyelitis Healing Plan

Advanced Diagnostic Workup

We assess the wound, review symptoms and risk factors, and coordinate appropriate testing such as labs, imaging, and tissue or bone cultures when needed to confirm the diagnosis and guide treatment.

Targeted Antibiotic Therapy

Antibiotic treatment should be guided by the suspected or confirmed organism, infection severity, culture results, and the patient's overall health. Our team coordinates antibiotic care with the appropriate medical specialists when needed.

Surgical Debridement Coordination

When infected or nonviable bone or tissue is present, we coordinate with surgical specialists to determine whether debridement, drainage, bone resection, or another procedure may be needed.

Advanced Wound Management

After surgical debridement, we manage the resulting wound with precision — selecting moisture-balanced antimicrobial dressings, negative pressure wound therapy (NPWT), and staged closure techniques tailored to the depth and complexity of the defect.

Hyperbaric Oxygen Therapy (HBOT)

For chronic refractory osteomyelitis that has not responded to conventional medical and surgical treatment, HBOT may be added as an adjunct therapy. HBOT helps increase oxygen delivery to infected bone, supports immune cell function, may enhance antibiotic activity, and can support healing as part of a broader physician-directed plan.

Biologic & Cellular Tissue Products

Once infection is controlled and the wound bed is appropriate, cellular and tissue-based products may be considered to support soft-tissue closure in select non-healing wounds.

Multidisciplinary Collaboration

Osteomyelitis treatment requires a team. We coordinate with orthopedic surgeons, infectious disease specialists, vascular surgeons, and your primary care provider — ensuring every aspect of your care is aligned and progressing toward healing.

Why Hill Country

San Antonio's Largest
Physician-Led Wound Care Network

From board-certified hyperbaric physicians to surgical coordination and three convenient locations, we deliver comprehensive, evidence-based osteomyelitis care — at a fraction of hospital costs.

Largest Private, Physician-Led Network

San Antonio's most extensive private outpatient wound care & hyperbarics network, led by board-certified physicians.

HBOT-Certified Physicians

Our board-certified hyperbaric physicians are experienced in the adjunctive HBOT protocols for refractory osteomyelitis — a specialized and underutilized treatment option.

Three Convenient Locations

Advanced Healing Centers in North, East, and Southwest San Antonio — with easy parking and convenient hours.

Affordable Outpatient Model

We accept Medicare and most major insurances. Our outpatient setup keeps your out-of-pocket costs lower than hospital-based programs.

Ready to start your healing journey? Our team is here to help.

From Our Blog

View all articles

Diabetic Health

Preventing Diabetic Foot Ulcers: Foot Care & Offloading Tips for South Texans

Diabetic foot ulcers are the most common source of osteomyelitis in wound care patients. Learn how diligent foot care, offloading, and early specialist involvement prevent bone infections before they start.

5 min readRead more

Hyperbaric

The Benefits of Hyperbaric Oxygen Therapy: Accelerating Healing and Recovery

HBOT is an evidence-based adjunct for refractory osteomyelitis — enhancing antibiotic activity, boosting immune response in avascular bone, and supporting healing after surgical debridement.

4 min readRead more

Wound Care

What Sets Hill Country Apart: Quality, Safety, and Experience in Every Visit

Osteomyelitis demands coordinated, physician-led care — antibiotics, debridement, HBOT, and specialist collaboration. Learn why Hill Country's model delivers better outcomes.

4 min readRead more

Osteomyelitis FAQs

Have more questions? Visit our full FAQ page or explore our articles.

Greater San Antonio

Concerned About a Bone Infection?

Osteomyelitis requires immediate specialist-level evaluation. Get expert care at any of our three San Antonio locations — most patients are seen within 48 hours.

(210) 610-8154

Osteomyelitis (Bone Infection) Treatment in San Antonio, TX

Hill Country Wound Care provides physician-led, multidisciplinary care for osteomyelitis in San Antonio, TX. Our board-certified specialists manage complex bone infections arising from diabetic foot ulcers, pressure injuries, trauma, and post-surgical complications. Our comprehensive approach combines coordination for surgical debridement, long-term targeted antibiotic therapy, and adjunctive Hyperbaric Oxygen Therapy (HBOT) for chronic refractory osteomyelitis, with a primary goal of limb salvage and preventing recurrence.

Understanding Osteomyelitis

Osteomyelitis is a serious infection of the bone. In wound care, it most often occurs via contiguous spread, where bacteria from a chronic, deep wound invade the underlying bone. The compromised blood supply in infected bone makes it difficult for the body's immune system and standard oral antibiotics to reach and eradicate the infection. This is why a combined approach of surgical removal of infected bone, long-term IV antibiotics, and therapies to improve oxygenation like HBOT is often necessary.

Our Treatment Protocol for Osteomyelitis

Our treatment is a coordinated, multi-pronged attack on the infection. 1) Diagnosis: We coordinate advanced imaging (MRI) and bone biopsy to confirm the diagnosis and identify the specific bacteria. 2) Surgical Debridement Coordination: We work with orthopedic or podiatric surgeons to plan for the removal of all infected and non-viable bone. 3) Infectious Disease Coordination: We collaborate with infectious disease specialists to manage the 4-6 week (or longer) course of targeted IV antibiotic therapy. 4) Advanced Wound Care: Post-debridement, we manage the complex surgical wound with NPWT and advanced dressings to achieve closure. 5) Adjunctive HBOT: For chronic, refractory cases, we provide HBOT to enhance oxygen delivery to the bone, improve antibiotic efficacy, and stimulate healing.

Hyperbaric Oxygen Therapy for Chronic Refractory Osteomyelitis

HBOT is a UHMS and Medicare-approved adjunctive therapy for chronic refractory osteomyelitis. By having patients breathe 100% oxygen in a pressurized chamber, we increase the amount of oxygen dissolved in the blood up to 15-fold. This hyper-oxygenated blood reaches the poorly vascularized infected bone, enhancing the killing ability of white blood cells, improving the efficacy of certain antibiotics, and stimulating the growth of new blood vessels to aid healing. HBOT is a critical tool that has been shown to improve resolution rates and reduce amputation risk in complex cases.