Hyperbaric Oxygen Therapy and Necrotizing Soft Tissue Infections

Some types of necrotizing soft tissue infections may benefit from treatment with hyperbaric oxygen. These include crepitant anaerobic cellulitis, progressive bacterial gangrene, necrotizing fasciitis, and non-clostridial myonecrosis.

Necrotizing soft tissue infections may result from either a single strain or a mixed group of bacteria and typically occur after trauma or surgery. Patients affected by such infections frequently have complicating conditions such as diabetes or vascular disease. These infections commonly lower tissue oxygen levels, impairing the ability of the white blood cells (neutrophils) to fight infection. Toxins produced by bacteria may also inhibit neutrophil activity.

The primary treatments for necrotizing soft tissue infection are antibiotics and surgical removal of infected tissue. In selected cases, the addition of hyperbaric oxygen therapy may be lifesaving.

Hyperbaric oxygen may be beneficial in several ways. Some of the bacteria involved in necrotizing soft tissue infections are “anaerobic”, growing most rapidly in a low oxygen environment. In the hyperbaric chamber, tissue oxygen levels may be raised sufficiently to inhibit bacterial growth. In addition, hyperbaric oxygen treatment enhances the ability of white blood cells to kill bacteria.

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