Gas Gangrene (myositis or myonecrosis)

Hyperbaric Oxygen Therapy Approval Status

Yes Clearance by US Food and Drug Administration (FDA)

Yes Approval by the Undersea and Hyperbaric Medical Society (UHMS)

About Clearance and Approval


Definition and Causes

Gas gangrene, also called clostridial myositis or myonecrosis, is a severe and rapidly spreading infection of muscle and other soft tissue. The bacteria that cause gas gangrene, of the species clostridium, most commonly Clostridium perfringens, produce liquid and gaseous poisons (toxins) that inflame (myositis) or kill (myonecrosis) healthy tissue. The advancing infection can threaten life and limb in mere hours.

Flesh-eating clostridium and other bacteria may originate in the gut, contaminated food, surgical incisions, community and healthcare environments, or soil embedded in traumatic wounds and bone fractures. The microorganisms surround themselves with toxins (alpha- or α-toxins) that interfere with the body’s natural immune response. Stopping toxin production as soon as possible is essential to prevent tissue loss, amputation, shock, and death.

Evidence Index

FDA cleared, widely reimbursed
Strong body of evidence
Repeatedly favorable results
Early or mixed results
Unfavorable or no evidence
Strong evidence against HBOT

Treatment with Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy, combined with antibiotics and surgical removal of dead tissue, is an effective treatment for gas gangrene. Clostridia are anaerobic, meaning they thrive in low-oxygen environments. HBOT stops toxin production and inhibits bacteria from replicating and spreading. Hyperbaric oxygen may also boost the effect of antibiotics, enhance the body’s natural defenses against bacteria, and help resolve or delay the onset of sepsis, a deadly blood poisoning.

Read the Clostridial Myositis and Myonecrosis (Gas Gangrene) page in the Undersea and Hyperbaric Medical Society resource library to learn more about gas gangrene, the rationale for hyperbaric oxygen therapy, and key clinical evidence, outcomes, and success factors.

HyperbaricLink Commentary

Clostridium perfringens is not to be confused with antibiotic-resistant Clostridium difficile (C. diff), an increasingly common source of healthcare-associated infections (HAIs). Gas gangrene does not involve C. diff. Nor can we find any good clinical evidence on the treatment of C. diff with hyperbaric oxygen. But early treatment of gas gangrene with hyperbaric oxygen, surgical debridement, and antibiotics combined has been shown to stop toxin production and significantly reduce mortality and morbidity compared with surgery alone. Do not expect further study. It may be considered unethical to conduct clinical trials on such gravely ill patients in critical need of standard combination therapy with HBOT.

Patient Resources

HyperbaricLink recommends the following websites for anyone seeking authoritative information, patient advocacy, and community support for gas gangrene.

Clostridium perfringens
US Centers for Disease Control and Prevention (CDC)

The CDC is dedicated to protecting health and promoting quality of life through the prevention and control of disease, injury, and disability. Its programs reduce the health and economic consequences of the leading causes of death and disability. The CDC website includes an informative page on Clostridium perfringens in its website section on food safety.

Foodborne Illnesses: What You Need to Know
US Food and Drug Administration (FDA)

The FDA puts Clostridium perfringens in its Bad Bug Book (BBB) as one of the most commonly reported causes of foodborne illnesses, with 10-12 outbreaks and over 10,000 individual cases every year. The page on food-borne illness describes sources and symptoms associated with disease-causing organisms.


A service of the US National Library of Medicine and the National Institutes of Health, MedlinePlus offers plenty of helpful links from its easy-to-read article on bacterial infections and gangrene.

Partnering to Heal
US Department of Health and Human Services (HHS) offers healthcare professionals and patients and families an excellent interactive video program about preventing healthcare-associated infections (HAIs).


The gas gangrene and Clostridium perfringens entries in Wikipedia provide some basic information about gangrene, with excellent microscopy and clinical photography.

Clinical Resources

Start with the following resources to explore current research activities and the peer-reviewed medical literature on hyperbaric oxygen therapy for gas gangrene.

 Use the search buttons below to go directly to research on hyperbaric oxygen therapy., National Institutes of Health keeps the official list of human clinical trials currently enrolling, in progress, and recently completed. One may reasonably question the size and legitimacy of any study not listed here.


Google Scholar

A specialized Google search engine, Google Scholar indexes scholarly articles, patents, and legal opinions and journals. Google Scholar may produce many search results, but entries provide easy access to full-text journal articles.

Search Google Scholar, US National Library of Medicine, National Institutes of Health

PubMed keeps the official list of scientific papers published in reputable peer-reviewed medical journals. One may reasonably question the importance and legitimacy of any study not listed here.


Partnering to Heal
US Department of Health and Human Services (HHS) offers healthcare professionals and patients and families an excellent interactive video program about preventing healthcare-associated infections (HAIs).

News About Gas Gangrene and Hyperbaric Oxygen Therapy

One Last Post Re: Success with Hyperbaric Oxygen Therapy for Necrotizing Infections

Tuesday, 7/17

Before we take a break from this topic, here's one more quick but inspiring story about success with hyperbaric oxygen therapy for deadly soft tissue infections, or flesh-eating disease, sometimes including gas gangrene or bone read more...

HBOT for Necrotizing Fasciitis: South Carolina Mother of Twins Going Home with All Her Limbs

Monday, 7/16

Lana Kuykendall, this year's "other" high-profile victim of necrotizing fasciitis, or flesh-eating disease, underwent extensive hyperbaric oxygen therapy as part of her remarkable recovery at Greenville Memorial Hospital in Greenv read more...

Necrotizing Fasciitis Postcript: Aimee Copeland in Rehab, Set to Return Home Next Month

Thursday, 7/12

The young woman we wrote about in May has won her life-or-death battle against necrotizing fasciitis or flesh-eating disease. Hyperbaric oxygen therapy played some role—we don't know the details—in Aimee Copeland's recovery from read more...

More news from O2.0 – the HyperbaricLink blog

Complete gas gangrene news archive from O2.0 — the HyperbaricLink blog

Further Learning

HyperbaricLink suggests "How to Make Salt Rising Bread"
by Jenny Bardwell and Susan Brown on

eHow logo

In their video Jenny and Susan present an old American recipe using the Clostridium perfringens bacterium instead of yeast for fermentation.

Related Terms

  • Alpha-toxin (α-toxin)
  • Antibiotic
  • Bacteria
  • Cellulitis
  • Chronic wounds
  • Clostridium difficile (C. diff)
  • Diabetic ulcers
  • Fasciitis
  • Flesh-eating bacteria
  • Fournier’s gangrene
  • Gangrene
  • Healthcare-associated infection (HAI)
  • Hospital-acquired infection (HAI)
  • Hypoxia
  • Methicillin
  • MRSA
  • Necrosis
  • Necrotizing infection
  • Nosocomial infection
  • Sepsis
  • Septic shock
  • Septicemia
  • Staphylococcus aureus
  • Streptococcus
  • Toxemia
  • Toxic shock syndrome


Undersea and Hyperbaric Medical Society, Indications, Clostridial Myositis and Myonecrosis (Gas Gangrene). Retrieved 02 May 2015.
Gas Gangrene, MedlinePlus, US National Library of Medicine. Retrieved 28 September 2011.
Page Data
Updated: 22 Jul 2015 05:30 PM
Created: 13 Jun 2009 12:00 AM
By: About the authors »