Hyperbaric oxygen therapy for Fournierʼs gangrene

Ziser, Avishai; Girsh, Zahava; Gozal, David; Melamed, Yuval; Adler, M.

doi:10.1097/00003246-198509000-00020

Cited by 26 publications

(12 citation statements)

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“…Hyperbaric oxygenation increases tissue oxygen tension to a level that inhibits and kills anaerobic bacteria, while also reducing systemic toxicity, limiting necrosis and enhancing demarcation of gangrene [34,43]. However, hyperbaric oxygen therapy seemed not to have any advantage in terms of morbidity und mortality rates [44].…”

Section: Intensive Care and Adjuvant Measuresmentioning

confidence: 99%

Necrotizing Fasciitis of the Perineum and the Abdominal Wall-Surgical Approach

Ecker¹,

Baars²,

Töpfer³

et al. 2008

Eur J Trauma Emerg Surg

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Necrotizing fasciitis is a synergistic aerobical-anaerobical infection that rapidly spreads from its origin leading to foudroyant increasing soft tissue gangrene and systemic sepsis. In the perineal, perianal and genital regions it is referred to as Fournier's gangrene constituting a clinical entity with the gangrene of the abdominal wall. After a short presentation of the own experience with 17 patients the surgical approach to the life-threatening disease is presented reviewing the former and the recent literature. There is a worldwide consensus that immediate radical excision of the gangrene should be accompanied by intensive care measures. Functional and cosmetic defects are to be reconstructed in a second stage. However, morbidity and mortality remain high in spite of consequent treatment due to often associated significant co-morbidity of affected patients.

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Section: Intensive Care and Adjuvant Measuresmentioning

confidence: 99%

Necrotizing Fasciitis of the Perineum and the Abdominal Wall-Surgical Approach

Ecker¹,

Baars²,

Töpfer³

et al. 2008

Eur J Trauma Emerg Surg

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“…Putative benefits of hyperbaric oxygen therapy include the provision of adequate oxygenation for optimal neutrophil phagocytic function, the inhibition of anaerobic growth by tissue hyperoxygenation, increased fibroblast proliferation and angiogenesis, reduction of oedema by vasoconstriction, increased intracellular transport of antibiotics and increased generation of oxygen free‐radicals. Although its role in Fournier’s gangrene is supported by several small, retrospective studies [ 66, 67], hyperbaric oxygen therapy should not delay definitive surgical treatment. It is probably best reserved for patients who remain toxic despite maximal debridement and those with clinical or microbiological evidence of anaerobic infection [ 10], particularly in view of the limited availability of hyperbaric chambers.…”

Section: Managementmentioning

confidence: 99%

Fournier’s gangrene

Smith

Bunker

Dinneen

1998

British Journal of Urology

276

228

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“…The efficacy of hyperbaric oxygen is applicable in clostridial and nonclostridial infections 30,31 . HBO increases the oxygen tension in tissues to a level that is inhibitory and lethal to anaerobic bacteria, while limiting necrosis and enhancing demarcation of gangrene [30][31][32][33] . However in a review of 42 patients with FG and in whom half were given HBO and another half not given, there was a higher mortality among the HBO patients 34 .…”

Section: Treatmentmentioning

confidence: 99%