What Researchers Did
Researchers conducted a systematic review following PRISMA guidelines, analyzing 21 studies comparing HBOT versus no HBOT in patients with necrotizing soft tissue infections (NSTI), with mortality as the primary outcome.
What They Found
The majority of studies reported a positive association between HBOT and lower mortality, but all 21 studies had high to critical risk of bias. Most were case series with control groups, not randomized trials. No high-quality evidence confirmed a mortality benefit from HBOT in NSTI.
What This Means for Canadian Patients
Necrotizing fasciitis is treated in Canadian surgical centers and carries very high mortality. While this review could not confirm HBOT benefit due to poor evidence quality, it also did not find evidence of harm. A Canadian-led randomized controlled trial in NSTI would meaningfully advance this field.
Canadian Relevance
No direct Canadian connection identified.
Study Limitations
All 21 included studies had high or critical risk of bias; without randomized controlled trials, the apparent mortality benefit of HBOT in NSTI cannot be reliably confirmed.