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Hyperbaric Oxygen Treatment for Necrotizing Fasciitis and Necrotizing Soft Tissue Infections

Not Applicable
Not yet recruiting
Conditions
Necrotizing Fascitis
Registration Number
NCT07170020
Lead Sponsor
Spectrum Health Hospitals
Brief Summary

The goal of this clinical trial is to learn if hyperbaric oxygen is beneficial in treating necrotizing infections and decreasing rates of morbidity and mortality. This study therefore has two aims:

1. Determine if hyperbaric oxygen improve morbidity and mortality compared to standard of care using a prospective model.

2. Determine if faster diagnosis to debridement times negate the need for hyperbaric oxygen treatments in necrotizing infections.

Detailed Description

Necrotizing fasciitis and necrotizing soft tissue infections are a complicated group of infections dominated largely by polymicrobial infections that rapidly spread through the skin and soft tissues. Secondary effects include vascular occlusion, ischemia, tissue necrosis, along with sepsis and multi-organ involvement. The incidence of necrotizing infections is about 6500 cases annually in the US2. There have been no major advances in disease management over the past twenty years and the mortality still ranges in the 10-43 % range2. Today early aggressive debridement and IV antibiotics remain the cornerstone of treatment. Hyperbaric oxygen has been shown in several case studies and retrospective studies to possibly improve mortality and morbidity in this patient population.1-4 One limitation of prior studies is many of them are retrospective. Additionally, not all centers are able to take patients quickly back for surgical debridement which could increase rates of morbidity and mortality. Corewell Health West Butterworth Hospital has 24/7 in-hospital acute care surgery services. This allows very short diagnosis to OR debridement wait times in necrotizing infections. This study therefore has two aims: first is to determine if hyperbaric oxygen improve morbidity and mortality compared to standard of care using a prospective model. Secondly, to determine if faster diagnosis to debridement times negate the need for hyperbaric oxygen treatments in necrotizing infections.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
160
Inclusion Criteria
  • Age: 18 years old
  • Patients with documented necrotizing fasciitis or necrotizing soft tissue infection as assessed during initial bedside evaluation, in conjunction with available laboratory values, imaging showing gas in soft tissues consitent with necrotizing infection, or surgical debridement of necrosis of fascia, muscle, and variable levels of soft tissue involvement
  • Patient or advocate is able to sign consent
Exclusion Criteria
  • Pediatric patients
  • Pregnant patients
  • Patients deemed unlikely to survive or unable to go to surgical debridement

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Mortality improvement6 months post procedure

To evaluate if the addition of hyperbaric oxygen improves mortality in patients with necrotizing fasciitis and necrotizing soft tissue infections.

Secondary Outcome Measures
NameTimeMethod
Morbitity6 months post procedure

To evaluate the morbidity of patients treated with standard of care including hyperbaric oxygen treatments as compared to historical controls.

Trial Locations

Locations (1)

Corewell Health

🇺🇸

Grand Rapids, Michigan, United States

Corewell Health
🇺🇸Grand Rapids, Michigan, United States
Kendra Selby
Contact
2694912506
kendra.selby@helendevoschildrens.org
Drue Orwig
Principal Investigator
John McGlynn
Sub Investigator
Elizabeth Steensma
Sub Investigator

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