Limb Salvage in Extensive Necrotizing Soft Tissue Infection with Adjuvant Hyperbaric Oxygen Therapy

A necrotizing soft tissue infection (NSTI) can be life-threatening if not treated promptly, posing a high risk of limb amputation. Here, we report a case of an NSTI extending from the buttocks and perineum down to the left lower limb. The case involved a 48-year-old male patient who presented with fever, altered consciousness, and limb swelling. Computed tomography showed the infection had spread to the perifascial, intermuscular, and intramuscular regions, making it difficult to save the patient's life and limb. Despite prompt surgery and antibiotic treatment, multidrug-resistant bacteria presented difficult wound management challenges. Hyperbaric oxygen therapy (HBO) was initiated, which resulted in dramatic wound improvement and successful skin grafting. Due to limb preservation, the patient was able to recover his preadmission activities of daily living and successfully reintegrate into society. Standard treatments for NSTI include early surgical treatment, antibiotics, and intensive support. The adjunctive use of HBO therapy may have contributed to the successful outcome in this case.