Definition and Causes
Gas gangrene, also called clostridial myositis or myonecrosis, is a severe and rapidly spreading infection of muscle and other
soft tissue. The bacteria that cause gas gangrene, of the species clostridium, most commonly Clostridium perfringens, produce
liquid and gaseous poisons (toxins) that inflame (myositis) or kill (myonecrosis) healthy tissue. The advancing infection can
threaten life and limb in mere hours.
Flesh-eating clostridium and other bacteria may originate in the gut, contaminated food, surgical incisions, community and
healthcare environments, or soil embedded in traumatic wounds and bone fractures. The microorganisms surround themselves with
toxins (alpha- or α-toxins) that interfere with the body’s natural immune response. Stopping toxin production as soon as possible
is essential to prevent tissue loss, amputation, shock, and death.
Hyperbaric Oxygen Approval Status
Read the
Clostridial Myositis and Myonecrosis (Gas Gangrene)
page in the Undersea and Hyperbaric Medical Society resource library to learn more about gas gangrene, the rationale for
hyperbaric oxygen therapy, and key clinical evidence, outcomes, and success factors.
Treatment with Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy, combined with antibiotics and surgical removal of dead tissue, is an effective treatment for gas
gangrene. Clostridia are anaerobic, meaning they thrive in low-oxygen environments. HBOT stops toxin production and inhibits
bacteria from replicating and spreading. Hyperbaric oxygen may also boost the effect of antibiotics, enhance the body’s natural
defenses against bacteria, and help resolve or delay the onset of sepsis, a deadly blood poisoning.
hyperbariclink commentary
Clostridium perfringens is not to be confused with antibiotic-resistant Clostridium difficile (C. diff), an increasingly
common source of healthcare-associated infections (HAIs). Gas gangrene does not involve C. diff. Nor can we find any good
clinical evidence on the treatment of C. diff with hyperbaric oxygen. But early treatment of gas gangrene with hyperbaric
oxygen, surgical debridement, and antibiotics combined has been shown to stop toxin production and significantly reduce
mortality and morbidity compared with surgery alone. Do not expect further study. It may be considered unethical to conduct
clinical trials on such gravely ill patients in critical need of standard combination therapy with HBOT.
Patient Resources
HyperbaricLink recommends the following websites for anyone seeking authoritative information, patient advocacy, and community
support for gas gangrene.
The CDC is dedicated to protecting health and promoting quality of life through the prevention and control of disease, injury,
and disability. Its programs reduce the health and economic consequences of the leading causes of death and disability. The
CDC website includes an informative page on
Clostridium perfringens
infections.
The FDA website (www.fda.gov) puts Clostridium perfringens in its Bad Bug Book (BBB) as one of the most commonly reported
causes of foodborne illnesses, with 10-12 outbreaks and over 10,000 individual cases every year.
A service of the US National Library of Medicine and the National Institutes of Health, MedlinePlus offers plenty of helpful
links from its easy-to-read article on
bacterial infections
and
gangrene.
Another service of the US National Library of Medicine and the National Institutes of Health, PubMed Health offers shorter
pages (with lots of links) on
necrotizing soft tissue infection
and
gangrene.
HHS.gov offers healthcare professionals and patients and families an excellent interactive video program,
Partnering to Heal
about preventing healthcare-associated infections (HAIs).
The
gas gangrene
and
Clostridium perfringens
entries in Wikipedia provide some basic information about gangrene, with excellent microscopy and clinical photography.
Clinical Resources
Start with the following resources to explore current research activities and the peer-reviewed medical literature on
hyperbaric oxygen therapy for gas gangrene.
ClinicalTrials.gov keeps the official list of human clinical trials currently enrolling, in progress, and recently completed.
One may reasonably question the size and legitimacy of any study not listed here.
Search ClinicalTrials.gov for current studies of hyperbaric oxygen therapy and gangrene
A specialized Google search engine, Google Scholar indexes scholarly articles, patents, and legal opinions and journals.
Google Scholar may generate excessive search results, but entries provide easy access to full-text journal articles.
Search Google Scholar for gangrene and hyperbaric oxygen
PubMed.gov
US National Library of Medicine
National Institutes of Health
PubMed keeps the official list of scientific papers published in reputable peer-reviewed medical journals. One may reasonably question the importance and
legitimacy of any study not listed here.
Search PubMed.gov for journal articles relating to hyperbaric oxygen therapy and gangrene
HHS.gov offers healthcare professionals and patients and families an excellent interactive video program,
Partnering to Heal
about preventing healthcare-associated infections (HAIs).
Related Terms
- Alpha-toxin (α-toxin)
- Antibiotic
- Bacteria
- Cellulitis
- Chronic wounds
- Clostridium difficile (C. diff)
- Diabetic ulcers
- Fasciitis
- Flesh-eating bacteria
- Fournier’s gangrene
- Gangrene
- Healthcare-associated infection (HAI)
- Hospital-acquired infection (HAI)
- Hypoxia
- Methicillin
- MRSA
- Necrosis
- Necrotizing infection
- Nosocomial infection
- Sepsis
- Septic shock
- Septicemia
- Staphylococcus aureus
- Streptococcus
- Toxemia
- Toxic shock syndrome
Further Learning
HyperbaricLink suggests
"How to Make Salt Rising Bread"
by Jenny Bardwell
and
Susan Brown
on
In their video Jenny and Susan present an old American recipe using the Clostridium perfringens bacterium instead of yeast for fermentation.