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Soft Tissue Infections with Tissue Necrosis

Soft Tissues Infections due to mixed aerobic and anaerobic organisms with tissue necrosis and refractory bacteroides infections including necrotizing fascitis, synergistic necrotizing cellulitis, progressive dermal gangrene, severe cases of anaerobic streptococcal myositis, and crepitant anaerobic cellulitis.


To be used as an adjunct to surgical and antibiotic treatment.


Organisms other than Clostridia can cause gangrenous infections. In these synergistic infections, one characteristic is the presence of bacterial species with differing oxygen requirements. Favorable clinical reports indicate an adjunctive role for hyperbaric oxygen in these difficult and often life-or-limb threatening infections. It is emphasized that primary management remains adequate surgical debridement and antibiotics, but hyperbaric oxygen is a useful adjunct in difficult cases.

The oxygen tension in infected soft tissue is low. Hyperbaric oxygen increases the tissue oxygen tension in infected tissue to levels where anaerobic organisms are inhibited or killed. The increase in tissue tension also allows the host defense cells -- polymorphonuclear leukocytes (PMN's) -- to optimally kill aerobic and anaerobic organisms. Clinical studies have demonstrated the beneficial effect of adjunctive HBO in mixed aerobic/anaerobic soft tissue infections.

Hyperbaric oxygen is adjunctive and must be used with appropriate antibiotics and surgical debridement. Hyperbaric oxygen must be used only as an adjunct to accepted surgical care and antibiotic treatment.

Cost Impact

The life-, limb-, and tissue-threatening aspects of these disorders justify the costs involved. Additionally, treatment times would not be expected to extend over 3-7 days.

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