Treating necrotizing fasciitis with or without hyperbaric oxygen therapy

Abstract

There is not enough clinical data to support the benefit of adjuvant HBO2 therapy for necrotizing fasciitis (NF). We retrospectively reviewed our 67 NF cases to compare the outcomes of adjuvant HBO2 therapy versus non-HBO2 therapy. The overall outcome and morbidity criteria were compared between a group of 29 NF patients who received the adjuvant HBO2 and a group of the remaining 38 NF patients treated by only surgery and other standards of care. This study did not find any difference between the groups in average length of hospital stay, and their mortality. However, six (25%) of the non-HBO2 group patients required amputation of extremities compared to one of the HBO2 group (Fisher exact p = 0.09). Although the benefit of adjuvant HBO2 therapy remains controversial for NF, and the outcomes of this study are not statistically significant, there is a trend in clinical outcomes which shows that the therapy has the potential to reduce the number of amputation and salvage extremities. These findings necessitate multicenter, prospective, case control study to assess the possible benefit of adjuvant HBO2 therapy for NF.