Hyperbaric Oxygen Therapy Is Associated with Lower Mortality in Patients with Fournier's Gangrene: A Meta-Analysis

Background and Objectives: The therapeutic management of Fournier's gangrene involves the use of broad-spectrum antibiotics and adequate surgical debridement; however, the overall mortality rate remains high globally. Hyperbaric oxygen therapy may serve as an adjunct treatment modality for reducing mortality in patients with Fournier's gangrene, but its efficacy remains debatable. Consequently, this meta-analysis assessed the effect of hyperbaric oxygen therapy on mortality in patients with Fournier's gangrene. Materials and Methods: To assess the effect of hyperbaric oxygen therapy on patients with Fournier's gangrene, various databases were meticulously searched by focusing on the study population, intervention, control, and mortality outcomes. Results: Fourteen studies, enrolling a total of 793 patients, including 356 in the hyperbaric oxygen therapy cohort and 437 in the nonhyperbaric oxygen therapy cohort, were included in this meta-analysis. Compared with the mortality rate of 27.45% in the control cohort, the rate in the hyperbaric oxygen therapy cohort was 9.55%. This difference between patients with Fournier's gangrene who underwent conventional therapy with hyperbaric oxygen therapy and those receiving only conventional therapy was significant (RR = 0.33; 95% CI 0.23-0.48; p < 0.001). Conclusions: Hyperbaric oxygen therapy may serve as an adjunct intervention to mitigate the increased risk of mortality among patients with Fournier's gangrene. Methodologically rigorous randomized controlled trials must be conducted to determine the appropriate dosage and therapeutic efficacy of hyperbaric oxygen therapy in these patients and identify specific patient cohorts poised to obtain a benefit from this treatment.