Gas Gangrene Treated With Hyperbaric Oxygenation

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A NEW approach to the treatment of gas gangrene is to administer oxygen under high pressure. This is achieved by placing the patient in an environment where the pressure of the oxygen can be raised to two or three atmospheres. A rise in partial pressure of oxygen in the alveoli occurs, with a consequent rise in the tension of oxygen in the arterial blood and tissues (approximately fifteen times when the patient is placed in an oxygen chamber at three atmospheres). The increased oxygen tension present at the border of the advancing infection creates an environment unfavorable to the further growth and multiplication of the anaerobic Clostridium perfringens. The spread of the gas gangrene is thus limited and the disease arrested.

Experimental studies with dogs1 and with rabbits2 revealed that after ligation of the hepatic arteries the mortality from clostridial hepatitis was greatly reduced by administering oxygen under high pressure. Brummelkamp3 treated 37 patients, who had clostridial infection, with hyperbaric oxygen with good results. Of the eight deaths in the series only one was directly and two were indirectly attributable to the gas gangrene. Wallyn and associates,4 who treated two patients with hyperbaric oxygen, found that there was a remarkable reversal of the gas gangrene infection. Three patients who had gas gangrene were treated by oxygen under pressure at approximately two atmospheres by Karasewich and associates1 and results were encouraging. VanZijl and Maartens5 treated nine patients, who had gas gangrene, with oxygen under pressure; six of these patients recovered.

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