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

Abstract

Necrotizing soft tissue infection is a severe life-threatening disease correlated with high mortality. Until now, therapeutic concepts include antimicrobial, intensive care and surgical interventions, as well as the application of hyperbaric oxygenation (HBO), which still has a controversial status. Evidence of the therapeutic concept of HBO is, so far, limited to positive experiences in case studies and physiological benefits in animal studies. That is why the HBO therapy method is not yet fully established. In this light, a retrospective data analysis was conducted. The analysis involved 91 intensive care patients in the Clinic for Anesthesiology and Surgical Intensive Care at the University Hospital Halle (Saale) who, because of a necrotizing soft tissue infection, were treated with HBO therapy (period of observation from 2008 to second quarter 2017). Treatment outcome was examined with regard to mortality, complications, time spent in the intensive care unit, and functional limitations. The criteria of therapy relevance, therapy management, and conclusions drawn from the treatment results were evaluated. By examining the result of combining all four categories of treatment, we aim to investigate established guidelines and their practicability. We expect treatment with HBO to have no disadvantages compared with acknowledged treatment concepts. This study considers the success of treatment as a result of complying with optimal therapy. In a contribution to establish coverage use and an inventory of hyperbaric chambers, we also aim to create a national case register, so that patients do not have to depend on long and risky transportations.