Treatment of gas gangrene. Interest of hyperbaric oxygen therapy

We report 27 cases of gas gangrene treated at the University Hospital of Liège since the Anesthesiology Department has been using a caisson for hyperbaric oxygen therapy. Frequency of gas gangrene does not appear to have decreased during recent years. The etiologies now encountered are mainly of post-traumatic and post-operative origin (especially surgery on the digestive tract); arterial insufficiency is a predisposing factor. The prognosis depends on the speed with which an effectual treatment is started; the latter consists in intensive hyperbaric oxygen therapy, antibiotic therapy and resuscitation. Surgery should be as conservative as possible and is undertaken only when progress of the disease has been checked by hyperbaric oxygen therapy. The association of these various modes of treatment proves effectual despite a still significant mortality.