Hyperbaric oxygen treatment: 10 years' experience of a Regional Infectious Diseases Unit.

Ten years' experience of a Regional Centre for Infectious Diseases in the use of hyperbaric oxygen in 87 patients have been reviewed. Its efficacy in the treatment of non-infectious cases has been confirmed. Fifty-eight (67 per cent) patients had anaerobic infections associated with peripheral vascular disease, limb trauma, abdominal surgery or occurred spontaneously. All patients had failed to respond to surgery and antimicrobial agents, and were transferred for hyperbaric treatment as the infection was progressive. Marked improvement in general condition, wound infection and limitation of extension of the anaerobic infection occurred following hyperbaric treatment. These improvements had benefits in terms of surgical risk, demarcation and mortality. Symptoms suggestive of oxygen toxicity occurred in up to 24 per cent of all patients, but in many this took the form of anxiety and anxiety-related symptoms. Despite the beneficial effects of hyperbaric oxygen, many surgeons appear to be unaware or sceptical of the facility. A prospective controlled trial is advocated.