[abstract] HYPERBARIC OXYGEN THERAPY REDUCES MORTALITY AND DEBRIDEMENTS FOR NECROTIZING FASCIITIS.

Abstract

Twenty-six patients with necrotizing fasciitis were treated from 1983 to 1988. This study evaluates how the addition of Hyperbaric Oxygen (HBO) therapy to surgical treatment has affected mortality and number of debridements required to achieve wound control in these patients. Two groups of patients were established in this review: group 1 (n=9) received surgical debridement and antibiotics only; group 2 (n=l?) received HBO (90 minutes at 2.5 atmospheres, average 7.4 treatments) in addition to surgery and antibiotics. Both groups were similar in age, race, sex, wound bacteriology and antibiotic regimen. Body surface area affected was similar; however, perineal involvement was more common in group 2 (53%) vs. group 1 (12%). The admitting condition of patients in each group is demonstrated in the following table:<table>-, Diabetic, WBC >12,000, Shock; Group 1 (non-HBO), 22 %, 33 %, 0; Group 2 (HBO), 42 %, 61 %, 29 %</table> Although group 2 patients receiving HBO were more critical on admission, mortality was significantly lower (22%) compared to group 1 (66%) (p<.05). In addition, only 1:2 debridements per group 2 patient were required to achieve wound control versus 4.0 debridements per group 1 patient. The addition of HBO therapy to the surgical and antibiotic treatment of necrotizing fasciitis significantly reduced mortality and wound morbidity (number of debridements) in this study. These results strongly support the routine use of HBO in treating this condition.