Treating necrotizing fasciitis with or without hyperbaric oxygen therapy

There is not enough clinical data to support the benefit of adjuvant HBO₂ therapy for necrotizing fasciitis (NF). We retrospectively reviewed our 67 NF cases to compare the outcomes of adjuvant HBO₂ therapy versus non-HBO₂ therapy. The overall outcome and morbidity criteria were compared between a group of 29 NF patients who received the adjuvant HBO₂ and a group of the remaining 38 NF patients treated by only surgery and other standards of care. This study did not find any difference between the groups in average length of hospital stay, and their mortality. However, six (25%) of the non-HBO₂ group patients required amputation of extremities compared to one of the HBO₂ group (Fisher exact p = 0.09). Although the benefit of adjuvant HBO₂ therapy remains controversial for NF, and the outcomes of this study are not statistically significant, there is a trend in clinical outcomes which shows that the therapy has the potential to reduce the number of amputation and salvage extremities. These findings necessitate multicenter, prospective, case control study to assess the possible benefit of adjuvant HBO₂ therapy for NF.