GAS GANGRENE 2

Gas Gangrene


Events
The established colonies of these organisms, leads to
production of toxins, which promote the further spread of the
infection, by invasion of uninjured tissue.
There is also a suppression of local immune defense and hemolytic action.

CLINICAL FEATURES
The incubation period is of 1-3 days
The patients present with history of injury, fever, and tachycardia.
- There is pain in the injured part and discharge of serous fluid
with a characteristic fishy adour.
- The skin shows change in color (pale to purple).
- Blebs appear on the surface.
- Crepitus under the skin or in the muscles is diagnostic.
The depth and extent of infection can be established by
X-ray examination and demonstration of gas in soft tissue
Death occurs with toxemia, septicemia.

TREATMENT
I)Early adequate surgical cleaning and debridement of all
contaminated wounds are the most effective means of prevention.
When in doubt of contamination, the wound can be left open(secondary suture)
ii)When diagnosed, multiple longitudinal incisions provide
decompression and exposure of the injured tissue to atmospheric
oxygen.
It also provides access to dead and damaged muscle which should
be excised.
iii)In late cases, amputation is required urgently.
iv) Antibiotic therapy with Penicillin or Tetracycline which is
effective.
v) Hyperbaric oxygenation can be used with success.
vi)In severe established cases giving of polyvalent gas gangerene
antitoxin may be considered.

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