A MULTICENTER REVIEW OF THE TREATMENT OF MAJOR TRUNCAL NECROTIZING INFECTIONS WITH AND WITHOUT HYPERBARIC-OXYGEN THERAPY

To examine the effectiveness of hyperbaric oxygen (HBO) therapy in the treatment of major truncal necrotizing infections, a retrospective (1 980 to 1992) analysis of the medical records of 39 patients treated wi th HBO therapy and 24 patients treated without HBO therapy was underta ken. The two groups were similar; however, there was a selection bias towards more frequent clostridial infections in a younger population i n the HBO group. There was no difference in length of hospital stay, i ntensive care unit (ICU) stay, or duration of antibiotic therapy betwe en groups. The mortality rates were 9/30 (30%) in the HBO group versus 10/24 (42%) (nonsignificant difference) in the non-HBO group. The tot al number of operations was greater in the HBO-treated group. This stu dy failed to show that the use of HBO in the treatment of major trunca l necrotizing infections statistically reduced mortality or the number of debridements. We believe, however, that the apparent selection bia s and the trend towards increased survival in the HBO-treated group (1 2%) justifies the continued use of and research with HBO therapy.