Evidence map›Paper›PMID 35932075›Full record

ArticleWorld journal of emergency surgery : WJES2022

Outcome of necrotizing fasciitis and Fournier's gangrene with and without hyperbaric oxygen therapy: a retrospective analysis over 10 years.

Assen Mladenov, Katharina Diehl, Oliver Müller, Christian von Heymann, Susanne Kopp, Wiebke K Peitsch

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of emergency surgery : WJES, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
6.8field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.

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  17. Fournier's gangrene due to rectal cancer: A case report.Molecular and clinical oncology · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Assen MladenovDepartment of Plastic, Reconstructive and Aesthetic Surgery - Center of Wound Medicine, Vivantes Klinikum im Friedrichshain, Berlin, Germany.
Katharina DiehlMannheim Institute of Public Health, Social and Preventive Medicine, Heidelberg University, Mannheim, Germany.
Oliver MüllerCenter of Hyperbaric Oxygen Therapy and Diving Medicine, Vivantes Klinikum im Friedrichshain, Berlin, Germany.
Christian von HeymannCenter of Hyperbaric Oxygen Therapy and Diving Medicine, Vivantes Klinikum im Friedrichshain, Berlin, Germany.
Susanne Kopp *Department of Plastic, Reconstructive and Aesthetic Surgery - Center of Wound Medicine, Vivantes Klinikum im Friedrichshain, Berlin, Germany.
Wiebke K Peitsch *Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany. wiebke.ludwig-peitsch@vivantes.de.
Klinikum im Friedrichshain · DEHeidelberg University · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNecrotizing soft tissue infections (NSTI) require immediate radical debridement, broad-spectrum antibiotics and intensive care. Hyperbaric oxygen therapy (HBOT) may be performed adjunctively, but unequivocal evidence for its benefits is still lacking.

methodsWe performed a retrospective single-center study including 192 patients with necrotizing fasciitis or Fournier's gangrene to assess in-hospital mortality and outcome dependent on patient, disease and treatment characteristics with or without HBOT.

resultsThe in-hospital mortality rate was 27.6%. Factors associated with increased mortality according to multivariate analysis were higher age, affection of multiple or problem localizations (odds ratio (OR) = 2.88, P = 0.003), ineligibility for HBOT despite clinical indication (OR = 8.59, P = 0.005), pathogens in blood cultures (OR = 3.36, P = 0.002), complications (OR = 10.35, P < 0.001) and sepsis/organ dysfunction (OR = 19.58, P < 0.001). Factors associated with better survival included vacuum-assisted wound closure (OR = 0.17, P < 0.001), larger number of debridements (OR = 0.83, P < 0.001) and defect closure with mesh graft (OR = 0.06, P < 0.001) or flap (OR = 0.09, P = 0.024). When participants were stratified into subgroups without requirement of HBOT (n = 98), treated with HBOT (n = 83) and ineligible for HBOT due to contraindications (n = 11), the first two groups had similar survival rates (75.5% vs. 73.5%) and comparable outcome, although patients with HBOT suffered from more severe NSTI, reflected by more frequent affection of multiple localizations (P < 0.001), sepsis at admission (P < 0.001) and intensive care treatment (P < 0.001), more debridements (P < 0.001) and a larger number of antibiotics (P = 0.001). In the subgroup ineligible for HBOT, survival was significantly worse (36.4%, P = 0.022).

conclusionThese results point to a benefit from HBOT for treatment of NSTI in critically ill patients.

Indexed as

Fasciitis, NecrotizingFournier GangreneHyperbaric OxygenationSepsisSoft Tissue InfectionsAnti-Bacterial AgentsDebridementHumansMaleRetrospective StudiesTreatment OutcomeAnti-Bacterial AgentsDebridementFournier's gangreneHyperbaric oxygen therapyNecrotizing fasciitisNecrotizing soft tissue infectionsVacuum-assisted wound closure

Identifiers

PMID35932075
PMCPMC9356491
OpenAlexW4290080889

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.