Hyperbaric oxygen as adjuvant therapy in the management of necrotizing fasciitis

Not Just Full of Hot Air: Hyperbaric Oxygen Therapy Increases Survival in Cases of Necrotizing Soft Tissue Infections

“…Both animal and human studies have shown that rich oxygen tissue states inhibit anaerobic infections and increase the oxidative burst ability of human leukocytes, which aid in the killing of bacteria [12,[21][22][23][24][25]. The theoretical basis for HBOT is two-fold.…”

“…Wheras a number of adjuvant therapies have been proposed-including specific therapies targeting bacterial toxins such as intravenous gamma globulin [7,8], plasmapheresis [9], and activated protein C [10,11] and the more generalized therapy of hyperbaric oxygen therapy (HBOT) [12,13]-there have been no universally accepted changes in the management of NSTI over the last three decades. Consequently, NSTI mortality has remained approximately 10-43% [14][15][16][17][18][19][20], and early diagnosis and aggressive site debridement remain the standard of care.…”

Hyperbaric Oxygen Therapy in the Treatment of Necrosis and Gangrene

“…Most authors have chosen a decrease of the overall mortality rate as an universal index of HBO therapy efficacy, reporting improved patients survival rates in majority of studies. The reported mortality rates varied significantly, from 0 to 33% (Jallali et al, 2005). The lowest mortality rate ever reported, essentially zero deaths after combined early surgical debridement and HBO therapy in small group of only 9 patients with Fournier's gangrene, was shown in the early clinical study of (Eltorai et al,1986).…”

A case of Fournier's gangrene after liver transplantation: Treated by hyperbaric oxygen therapy

“…HBO may help decrease the number of debridements required (4,5) HBO increases tissue oxygen tension to a high level that in turn inhibits and kills anaerobic bacteria while suppressing aerobic bacteria proliferation (5). Thus, HBO may be suitable for post-LDLT patients as a supplemental protocol.…”