Hyperbaric Oxygen Therapy in Necrotizing Soft Tissue Infections: A Retrospective Study

Area of Science:

• Medicine
• Surgery
• Intensive Care

Background:

• Necrotizing soft tissue infection (NSTI) is a severe, life-threatening condition with high mortality.
• Current treatments include antimicrobials, intensive care, surgery, and hyperbaric oxygenation (HBO), though HBO's role remains controversial.
• Existing evidence for HBO in NSTI is limited to case studies and animal research.

Purpose of the Study:

• To evaluate the efficacy and safety of hyperbaric oxygenation (HBO) therapy in patients with necrotizing soft tissue infections.
• To assess treatment outcomes including mortality, complications, intensive care unit (ICU) stay, and functional limitations.
• To investigate the practicability of established guidelines and the role of HBO in NSTI management.

Main Methods:

• Retrospective data analysis of 91 intensive care patients with NSTI treated with HBO therapy.
• Observation period from 2008 to Q2 2017 at the University Hospital Halle (Saale).
• Evaluation of therapy relevance, management, and treatment conclusions, considering mortality, complications, ICU duration, and functional outcomes.

Main Results:

• Hyperbaric oxygenation (HBO) therapy demonstrated no observed disadvantages compared to established treatment concepts for necrotizing soft tissue infections.
• Analysis of combined treatment categories suggests HBO can be integrated into optimal therapy strategies.
• The study provides data supporting the use of HBO in NSTI management, contributing to national case register efforts.

Conclusions:

• Hyperbaric oxygenation (HBO) therapy is a viable treatment option for necrotizing soft tissue infections, showing comparable outcomes to standard care.
• Implementing HBO therapy according to optimal protocols may enhance patient recovery and reduce complications.
• Establishing a national case register for HBO therapy in NSTI is recommended to facilitate wider access and reduce patient transport risks.