Definition and Causes
Necrotizing soft tissue infections are rare, serious, and sometimes life-threatening bacterial infections. Necrotizing
fasciitis, or flesh-eating disease, is the most widely known infection of this type. Necrosis means the death of cells and
tissue. Skin, muscle, and connective tissue infected with bacteria may suffer hypoxia, or a lack of oxygen, and die.
Flesh-eating disease may be caused by a number of different bacteria, in a single strain or mixed, originating within the
body, in chronic or traumatic wounds, or from foreign matter. For a listing of bacteria and associated diseases see the
Related Terms on this page. One increasingly common cause of flesh-eating disease is MRSA, or methicillin-resistant
Staphylococcus aureus, which has become a particularly troublesome hospital- and healthcare-acquired infection (HAI).
Hyperbaric Oxygen Approval Status
Read the
Necrotizing Soft Tissue Infections
page in the Undersea and Hyperbaric Medical Society resource library to learn more about flesh-eating disease, the rationale
for hyperbaric oxygen therapy, and key clinical evidence, outcomes, and success factors.
Treatment with Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy (HBOT) is emerging as an adjunct to traditional surgery and antibiotic therapy for these special
kinds of problem wounds. Some of the bacteria involved are anaerobic, meaning they thrive in low-oxygen environments. HBOT
inhibits anaerobic and some other bacteria from replicating, spreading, and releasing damaging toxins. Hyperbaric oxygen may
also boost the effect of antibiotics, enhance the body’s natural defenses against flesh-eating bacteria, and help resolve
or delay the onset of sepsis, a deadly blood poisoning.
hyperbariclink commentary
Hyperbaric oxygen can be a potent bactericide and also treats the hypoxia at the root of soft tissue necrosis. One analysis
[Undersea Hyperb. Med. 2005 Nov-Dec; 32(6):437-43]
showed significantly fewer deaths and amputations with HBOT. As the
[UHMS]
writeup concludes: “With such strong case series evidence of reductions in morbidity and mortality for necrotizing
fasciitis and the subset of Fournier's Gangrene, it is difficult to envision ever seeing a controlled, double-blinded
study of hyperbaric oxygen therapy.” In other words, considering the deadly seriousness of necrotizing infection and the
demonstrated effectiveness of HBOT, withholding treatment from a control group for comparative study would not be medically
or ethically acceptable. As antibiotics and other traditional weapons against these worrisome microscopic invaders begin
to weaken, HBOT provides a vital backstop.
Patient Resources
HyperbaricLink recommends the following websites for anyone seeking authoritative information, patient advocacy, and community
support for necrotizing infections.
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 informative pages on
necrotizing staph (MRSA)
and
strep (GAS)
infections.
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.
Another service of the US National Library of Medicine and the National Institutes of Health, PubMed Health offers a short
page (with lots of links) on necrotizing soft tissue infection.
HHS.gov offers healthcare professionals and patients and families an excellent interactive video program,
Partnering to Heal
about preventing healthcare-associated infections (HAIs).
Clinical Resources
Start with the following resources to explore current research activities and the peer-reviewed medical literature on
hyperbaric oxygen therapy for necrotizing infections.
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 necrotizing infections
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 "necrotizing infections" and "hyperbaric oxygen"
The IDSA provides information, education, and practice guidelines for physicians, scientists, and other healthcare
professionals who specialize in infectious diseases.
The MRSA Research Center is a leader in clinical and laboratory research and the go-to information resource for infection
control professionals and people affected by methicillin-resistant Staphylococcus aureus.
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 necrotizing infections
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
- Anthrax
- Antibiotic
- Bacteria
- Cellulitis
- Chronic wounds
- Clostridial myonecrosis
- Clostridial myositis
- Clostridium
- Diabetic ulcers
- Drug-resistant staph
- Erysipelas
- Fasciitis
- Flesh-eating bacteria
- Fournier’s gangrene
- Gangrene
- Group A streptococcus (GAS)
- Healthcare-acquired infection (HAI)
- Hospital-acquired infection (HAI)
- Hypoxia
- Lyell’s disease
- Methicillin
- MRSA
- Necrosis
- Nonclostridial myonecrosis
- Nonclostridial myositis
- Nosocomial infection
- Omphalitis
- Pseudomonas
- Ritter’s disease
- Scalded skin syndrome
- Sepsis
- Septic shock
- Septicemia
- Staphylococcus aureus
- Streptococcus
- Toxic shock syndrome
- Vibrio vulnificans