Necrotizing Infections

Hyperbaric Oxygen Therapy Approval Status

Yes Clearance by US Food and Drug Administration (FDA)

Yes Approval by the Undersea and Hyperbaric Medical Society (UHMS)

About Clearance and Approval


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).

Evidence Index

FDA cleared, widely reimbursed
Strong body of evidence
Repeatedly favorable results
Early or mixed results
Unfavorable or no evidence
Strong evidence against HBOT

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.

Read the page Necrotizing Soft Tissue Infections 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.

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 ] 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 hyperbaric oxygen therapy, 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.

Methicillin-resistant Staphylococcus aureus (MRSA) Infections
Group A Streptococcal (GAS) Disease
US Centers for Disease Control and Prevention (CDC)

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 sections on these two types of infection.


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.

Partnering to Heal
US Department of Health and Human Services (HHS) offers healthcare professionals and patients and families an excellent interactive video program 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.

 Use the search buttons below to go directly to research on hyperbaric oxygen therapy.
US National Institutes of Health 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.


Google Scholar

A specialized Google search engine, Google Scholar indexes scholarly articles, patents, and legal opinions and journals. Google Scholar may produce many search results, but entries provide easy access to full-text journal articles.

Search Google Scholar

Infectious Diseases Society of America (IDSA)

The IDSA provides information, education, and practice guidelines for physicians, scientists, and other healthcare professionals who specialize in infectious diseases.

MRSA Research Center
University of Chicago Medical Center

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.
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.


Partnering to Heal
US Department of Health and Human Services (HHS) offers healthcare professionals and patients and families an excellent interactive video program about preventing healthcare-associated infections (HAIs).

News About Necrotizing Infections and Hyperbaric Oxygen Therapy

One Last Post Re: Success with Hyperbaric Oxygen Therapy for Necrotizing Infections

Tuesday, 7/17

Before we take a break from this topic, here's one more quick but inspiring story about success with hyperbaric oxygen therapy for deadly soft tissue infections, or flesh-eating disease, sometimes including gas gangrene or bone read more...

HBOT for Necrotizing Fasciitis: South Carolina Mother of Twins Going Home with All Her Limbs

Monday, 7/16

Lana Kuykendall, this year's "other" high-profile victim of necrotizing fasciitis, or flesh-eating disease, underwent extensive hyperbaric oxygen therapy as part of her remarkable recovery at Greenville Memorial Hospital in Greenv read more...

Necrotizing Fasciitis Postcript: Aimee Copeland in Rehab, Set to Return Home Next Month

Thursday, 7/12

The young woman we wrote about in May has won her life-or-death battle against necrotizing fasciitis or flesh-eating disease. Hyperbaric oxygen therapy played some role—we don't know the details—in Aimee Copeland's recovery from read more...

More news from O2.0 – the HyperbaricLink blog

Complete necrotizing infections news archive from O2.0 — the HyperbaricLink blog

Further Reading

HyperbaricLink suggests Superbug: The Fatal Menace of MRSA, by Maryn McKenna (Free Press, 2010).

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


Undersea and Hyperbaric Medical Society, Indications, Necrotizing Soft Tissue Infections. Retrieved 02 May 2015.
Necrotizing soft tissue infection, MedlinePlus, US National Library of Medicine. Retrieved 10 May 2010.


Page Data
Updated: 27 Jul 2015 03:07 PM
Created: 14 Sep 2011 06:30 PM
By: About the authors »