Hyperbaric Oxygen Therapy for Gas Gangrene (Clostridial Myonecrosis)
Gas gangrene, clinically known as clostridial myonecrosis, is a rare but rapidly progressive and life-threatening infection of muscle tissue. It is caused by Clostridium bacteria, which thrive in low-oxygen environments and produce toxins that destroy tissue at an alarming rate. Immediate medical intervention is essential, and Hyperbaric Oxygen Therapy (HBOT) is recognised as an important adjunctive treatment alongside surgery and antibiotics.
By dramatically increasing oxygen levels within affected tissues, HBOT helps inhibit bacterial growth, limit toxin production, and support tissue survival.
Understanding Gas Gangrene
Gas gangrene most commonly develops following trauma, surgery, or deep wounds where blood supply is compromised. The condition can also occur spontaneously in rare cases, particularly in individuals with underlying vascular disease or immune compromise.
Once established, the bacteria release powerful toxins that cause muscle death, gas formation within tissues, and systemic toxicity. Symptoms typically progress quickly and may include severe pain at the wound site, swelling, skin discolouration, blistering, fever, and signs of shock. Without rapid treatment, the infection can spread extensively and become fatal.
Why HBOT Is Used in Gas Gangrene
Clostridial bacteria are anaerobic, meaning they cannot survive in oxygen-rich environments. Hyperbaric Oxygen Therapy directly targets this vulnerability while supporting the body’s ability to recover.
Key Effects of HBOT
1. Suppresses Bacterial Growth
High oxygen concentrations inhibit the growth of Clostridium species, limiting further spread of infection.
2. Reduces Toxin Production
HBOT has been shown to decrease the release of harmful bacterial toxins that cause tissue destruction and systemic illness.
3. Improves Oxygen Delivery to Damaged Tissue
Increased oxygen availability helps restore tissue viability in areas where circulation has been compromised.
4. Enhances Immune Response
HBOT improves the effectiveness of white blood cells, supporting the body’s ability to fight infection.
HBOT as Part of a Multidisciplinary Treatment Approach
HBOT is not a standalone treatment for gas gangrene. It is used alongside urgent surgical intervention and intravenous antibiotics. Surgery is required to remove necrotic tissue, reduce bacterial load, and prevent further toxin release. HBOT complements this approach by creating conditions that slow bacterial progression and support healing in surrounding tissues.
Treatment is usually initiated as soon as the diagnosis is suspected and may involve multiple hyperbaric sessions over several days, depending on severity and response.
HBOT Delivery in the UK
In the UK, patients with suspected gas gangrene are managed in acute hospital settings with referral to regional hyperbaric centres where appropriate. Treatment follows established national and international protocols, with patients closely monitored by multidisciplinary teams that may include surgeons, infectious disease specialists, and hyperbaric medicine clinicians.
Outcomes and Recovery
- Reduced spread of infection
- Lower toxin-related tissue damage
- Improved survival rates
- Greater preservation of limb and muscle function
Early diagnosis and immediate intervention remain the most critical factors in achieving positive outcomes.
FAQs About Gas Gangrene and HBOT
HBOT is strongly recommended in many cases but is used as an adjunct to surgery and antibiotics, not a replacement.
Treatment is most effective when started as early as possible after diagnosis, often within hours.
While not guaranteed, HBOT may help limit tissue damage and improve the chances of preserving affected limbs.
No, it does not spread from person to person. It develops when bacteria enter a suitable wound environment.
Yes. When delivered in a controlled hospital setting, HBOT is considered safe and well-tolerated.
Gas gangrene is a medical emergency requiring immediate, aggressive treatment. Hyperbaric Oxygen Therapy plays a valuable role in managing clostridial myonecrosis by suppressing bacterial growth, reducing toxin production, and supporting tissue recovery. When integrated into a multidisciplinary treatment plan that includes surgery and antibiotics, HBOT can significantly improve outcomes and help limit the devastating effects of this rapidly progressing infection.