Monday, September 19, 2011

Update: Hyperbaric Oxygen for Necrotizing Infections

Today we have upgraded our Necrotizing Infections page. Flesh-eating disease and other soft tissue infections 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. We list many of the bacteria and associated diseases under Related Terms on our new page.

One increasingly common cause of flesh-eating disease is MRSA, or methicillin-resistant Staphylococcus aureus, a particularly troublesome hospital- and healthcare-acquired infection (HAI). Each year, 90,000 Americans suffer from invasive MRSA infection. About 20,000 die. Many are children. [MRSA Research Center, University of Chicago]

Necrosis means death. Skin, muscle, and connective tissue infected with flesh-eating bacteria die because they are starved of oxygen. Only hospital-affiliated advanced wound care centers provide hyperbaric oxygen therapy for MRSA or other necrotizing infections. Time is tissue, the experts say, and hyperbaric oxygen kills bacteria, boosts the effect of antibiotics, enhances the body’s natural defenses against flesh-eating bacteria, and helps resolve or delay the onset of sepsis, a deadly blood poisoning.

From our new 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 Nov-Dec; 32(6):437-43] 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 HBOT, 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.

Again, we do not consider it unreasonable for the US healthcare community to demand access to an emergency-ready and professionally staffed hyperbaric chamber in every hospital.

[Photo: Staphylococcus aureus]

No comments:

Post a Comment