HBOT for Necrotising Soft Tissue Infections

UHMS-approved as adjunct to surgical debridement and antibiotics for necrotising fasciitis and gas gangrene.

HBOT Hub — http://localhost:3003/conditions/necrotising-infections · Printed October 11, 2026 · UHMS approved · Emergency · Life-threatening

GRADE Evidence Rating

No RCTs — observational data show mortality benefit. UHMS-approved based on biological plausibility and clinical consensus.

Overview

HBOT is a UHMS-approved adjunctive therapy for necrotising soft tissue infections (necrotising fasciitis, gas gangrene, Fournier gangrene). Hyperoxia is directly toxic to anaerobic organisms including Clostridium perfringens, and enhances neutrophil-mediated killing of anaerobes. Does not replace surgical debridement.

How HBOT Works

Hyperoxia at 2.5–3.0 ATA is directly bactericidal to anaerobes (Clostridium perfringens and others) and bacteriostatic to many facultative organisms. Alpha-toxin production by C. perfringens is suppressed. Neutrophil-mediated bacterial killing — which is oxygen-dependent — is substantially enhanced. Antibiotic penetration into poorly vascularised infected tissue improves.

Clinical Protocol

Standard protocol: 2.5–3.0 ATA sessions, 90 minutes with air breaks. Three sessions in the first 24 hours (every 6–8 hours), then twice daily for 48 hours, then daily. Coordinated with surgical and critical-care teams. Total 5–20 sessions depending on clinical course.

Cautions & Considerations

Typical protocol	3 sessions in first 24 hours at 2.5–3.0 ATA
Evidence level	Moderate — UHMS approved
FDA / regulatory status	FDA-approved indication

Does not replace urgent surgical debridement — adjunct only.
Patients are typically critically ill — requires multiplace capability.
Must be initiated urgently; delay reduces benefit.

Key Research

Indexed studies

Questions to Ask Your Doctor

Am I a candidate for HBOT for this condition given my medical history and current treatments?
What pressure (ATA) and session count would you recommend, and why?
Is treatment at this centre UHMS-accredited? What is the chamber type (monoplace or multiplace)?
What is the expected response rate and typical timeline for improvement?
What are the specific contraindications and side-effect risks in my case?
What is the expected cost and insurance coverage status?
What alternative or complementary treatments should I consider?
How will we measure whether treatment is working?