OxyFile #359

Gas gangrene: potential for hyperbaric oxygen therapy.

Stephens MB

Naval Hospital Bremerton, WA 98312, USA.

Postgrad Med, 99: 4, 1996 Apr, 217-20, 224

Abstract

Clostridial myonecrosis (gas gangrene) is an uncommon sequela of 
traumatic injury. Infection with Clostridium perfringens in 
devitalized tissue is the most common cause. Wide surgical 
debridement and appropriate antibiotic therapy remain the standard 
of care. However, the addition of hyperbaric oxygen therapy to 
standard management has been shown to have a synergistic effect in 
reducing morbidity and mortality in both canine and murine models. 
Although no prospective human data are available, retrospective 
data indicate that concomitant hyperbaric oxygen therapy has 
resulted in a twofold reduction in mortality. Where feasible, 
hyperbaric oxygen therapy should routinely be incorporated into 
the treatment plan for gas gangrene. Primary care physicians are 
in a unique position not only to make an early diagnosis but also 
to have a central role in coordinating multidisciplinary care 
often needed for this potentially fatal infection.