GAS-GANGRENE - POTENTIAL FOR HYPERBARIC-OXYGEN THERAPY

Clostridial myonecrosis (gas gangrene) is an uncommon sequela of traum atic injury. Infection with Clostridium perfringens in devitalized tis sue is the most common cause. Wide surgical debridement and appropriat e antibiotic therapy remain the standard of care. However, the additio n of hyperbaric oxygen therapy to standard management has been shown t o have a synergistic effect in reducing morbidity and mortality in bot h canine and murine models. Although no prospective human data are ava ilable, retrospective data indicate that concomitant hyperbaric oxygen therapy has resulted in a twofold reduction in mortality. Where feasi ble, hyperbaric oxygen therapy should routinely be incorporated into t he treatment plan for gas gangrene. Primary care physicians are in a u nique position not only to make an early diagnosis but also to have a central role in coordinating multidisciplinary care often needed for t his potentially fatal infection.