Gas gangrene is an infection caused by the clostridium bacillus, the most common
being Clostridium perfringens . Clostridial myositis and myonecrosis (gas gangrene)
is an acute, rapidly growing invasive infection of the muscle. It is characterized
by profound toxemia, extensive edema, massive death of tissue, and a variable
degree of gas production. The most prevalent toxin is the alpha-toxin which in
itself is hemolytic, tissue-necrotizing, and lethal. The diagnosis of gas gangrene
is based on clinical data supported by a positive (Gram-stained) smear obtained
from tissue fluids; X-ray radiographs, if obtained, can visualize tissue gas.
A treatment approach utilizing HBO is an adjunct to antibiotic therapy and surgery.
Initial surgery may be limited to opening the wound. Debridement of necrotic
tissue can be performed between HBO treatments when clear demarcation between
dead and viable tissue is evident. The sooner HBO treatment is initiated, the
better the outcome is in terms of life, limb, and tissue saving.