[Gas gangrene and hyperbaric oxygenation--a lesson forgotten or never learned?]

Gas gangrene develops in devitalized hypoxic tissue. It spreads rapidly under strong influence of enzymes produced by the causing bacteria and often results in fatal outcome. It is of utmost importance to stop toxin production as soon as possible, which is most effectively achieved by early application of hyperbaric oxygenation (HBO2), as the first measure in a "trident" (HBO2, antibiotics, surgical measures). The paper reviews the most important data from microbiology, pathophysiology and epidemiology of gas gangrene, current clinical practice, scientific basis for application of HBO2 in the treatment of this disease, and data from the archives of the Naval Medical Institute of the Croatian Navy in Split (NMI). At the NMI, in the period from 1982 to 2000, HBO2 was administered in the treatment of 21 patients with gas gangrene, of average age 41.6 +/- 16.3 years. The average treatment consisted of 6.8 +/- 3.8 sessions. 13 (76%) patients were cured.