Levett
No randomised evidence available to support or refute the use of hyperbaric oxygen in necrotising infections.
Clinical Bottom Line:
1. No randomised data is available for this clinical question
Citation:1. Levett DZ, Bennett MH, Millar I. Adjunctive hyperbaric oxygen for necrotizing fasciitis. Cochrane Database of Systematic Reviews 2015, Issue 1. Art. No.: CD007937. DOI: 10.1002/14651858.CD007937.pub2.
Background
Hyperbaric oxygen therapy (HBOT) has been used as an adjunct to surgery and antibiotics in the treatment of patients with necrotizing fasciitis with the aim of reducing morbidity and mortality.
Objectives
To review the evidence concerning the use of HBOT as an adjunctive treatment for patients with necrotizing fasciitis (NF). Specifically, we wish to address the following questions.
1. Does administration of HBOT reduce mortality or morbidity associated with NF?
2. What adverse effects are associated with use of HBOT in the treatment of individuals with NF?
Search methods
We searched an array of primary source databases from inception to September 2014. In addition, we performed a systematic search of specific hyperbaric literature sources. This included handsearching of relevant hyperbaric textbooks; hyperbaric journals and conference proceedings.
Selection criteria
We included all randomized and pseudo‐randomized trials (trials in which an attempt at randomization has been made but the method was inappropriate, for example, alternate allocation) that compared the effects of HBOT with the effects of no HBOT (no treatment or sham) in the treatment of children and adults with necrotizing fasciitis.
Data collection and analysis
We planned independent data collection by two review authors using standardized forms.
Main results
We found no trials that met the inclusion criteria.
Authors' conclusions
This systematic review failed to locate relevant clinical evidence to support or refute the effectiveness of HBOT in the managementof necrotizing fasciitis. Good quality clinical trials are needed to define the role, if any, of HBOT in the treatment of individuals with necrotizing fasciitis.
Expiry date: October 2025
