Gas gangrene is caused by gas-producing bacteria such as Clostridium perfringens infecting crushed or puncture wounds in an anaerobic environment. It leads to localized muscle death and tissue necrosis. Symptoms include pain, fever, and swelling at the wound site with a foul odor. The infection can spread rapidly without prompt treatment which includes intravenous antibiotics, debridement of dead tissue, and possibly amputation of an affected limb. Untreated gas gangrene has high mortality rates due to sepsis and organ failure.
2. What is a Gangrene?
localized cell death by obstructed circulation with
superadded bacterial infection.
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3. What is a Gas Gangrene?
Gangrene produced gas producing organisms like
Clostridium perfringens(welchii)
Oedematous myonecrosis – Skeletal muscle
Malignant edema
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08-02-2016GAS GANGRENE BY DR.R.DURAI MGMCRI
10. EFFECTS
Anaerobic myositis/myonecrosis. – Hydrogen Sulphide gas
–black/ brown muscle
Extensive spread – thoracic & abdominal wall
Foaming Liver
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08-02-2016GAS GANGRENE BY DR.R.DURAI MGMCRI
11. Clinical Features
Incubation period is 1-2 days
Toxaemia
Fever
Tachycardia
Pallor
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GAS GANGRENE BY DR.R.DURAI MGMCRI
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12. Contd…
Wound is under tension with foul smelling discharge (sickly
sweety/decaying apple odour).
Khaki brown coloured skin
Crepitus
Jaundice ,oliguria
Frequent sites are adductor region of the lower limb and buttocks and
subscapular region in upper limb.
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13. Clinical Types
Fulminant type
Massive type
Group type
Single muscle type
Subcutaneous type
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14. Investigations
X-ray
LFT ,RFT, ABG
CT
Gram Stain
Robertson’s Cooked meat media – meat to turn pink with
sour smell and acid reaction.
Nagler reaction.
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15. Complications
Septicaemia, toxaemia.
Renal failure, liver failure.
Circulatory failure, DIC, secondary infection.
Death occurs in critically ill patients.
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16. Treatment
Injection benzyl penicillin 20 lacs 4th hourly + Injection
metronidazole 500 mg 8th hourly + Injection
aminoglycosides (if blood urea is normal) or third
generation cephalosporins or metronidazole.
Fresh blood transfusion
Polyvalent antiserum 25,000 units given intrav enously after
a test dose and repeated after 6 hours
Hyperbaric oxygen
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17. Contd…
Radical Wound Debridement
Rehydration
Amputation
Ventilator support
Fumigation of theatre after treatment
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