Gas Gangrene

Gas gangrene is an infection that causes the body’s soft tissues to be destroyed by toxins produced by bacteria.  In 80% to 90% of cases, it is caused by Clostridium perfringens.  Gas gangrene may follow surgery or massive trauma/injury of accidents or battlefield injuries.  The infection is characterized by blood poisoning, massive swelling, death of tissue and the production of toxic gas in the affected area.

The patient may develop life-threatening anemia, kidney failure, jaundice, brain dysfunction, and heart problems.  About 1,100 Americans die of gas gangrene each year.  Clostridium perfringens is an anaerobic bacteria; it thrives in the absence of oxygen.  The original injury results in hypoxia and the bacteria multiply and produce waste products that are toxic to the body and cause swelling.  Swelling further diminishes the availability of oxygen and keeps the immune system from functioning optimally.  The disease spreads and produces more of the highly toxic substances.  The patient can become critically ill in a matter of 12 hours.

Antibiotics and surgery are the main conventional medical treatments for gas gangrene.  HBOT works adjunctively by helping to kill the bacteria and mitigate the toxicity of the waste products.  The dead tissue also creates toxins and surgery is often indicated for HBOT to work on the infection.  When the dead tissue is removed the oxygen can act aggressively against the bacteria.

The combination of surgery and HBOT helps clarify the line between live tissue and dead tissue, so the dead tissue can be surgically removed.  In this way, HBOT can reduce the number and extent of amputations.  A treatment that involves antibiotics, surgery and HBOT causes survival rates to increase to up to 95%.46

There is a gas gangrene antitoxin, but it produces adverse reactions in about 10% of patients.  Oxygen should be administered at 3.0 ATA in 90-minute sessions twice a day until the patient improves.  This can take up to 12 sessions, although usually only three to four are needed.

Risk of death in a patient with truncal gangrene is 75% if HBOT is started more than 24 hours after diagnosis.  If treatment is initiated in less than 24 hours, the risk decreases to 18%. When a limb is involved, mortality rate approaches 0 if HBOT is started in less than 24 hours, and if after 24 hours the mortality rate is more than 9%.

The action of hyperbaric oxygen on Clostridia (and other anaerobes) is based on the formation of oxygen free radicals that the anaerobes are particularly vulnerable to (superoxide dismutases, catalases, and peroxidases).

Notes
46Neubauer, 68.