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Gas Gangrene
Gangrene refers to the death of body tissue due to
either a lack of blood flow or a serious bacterial
infection. Gangrene commonly affects the
extremities, including your toes, fingers and limbs,
but it can also occur in your muscles and
internal organs.
Types of gangrene:-
1.Dry gangrene.
2.Wet gangrene.
3.Gas gangrene.
4.Internal gangrene.
5.Fourniers gangrene.
DEFINITION:
It is a highly fatal, rapidly spreading infection caused
By clostridial organisms which results in
myonecrosis.
Gas gangrene also known as Clostridial myositis,
clostridial myonecrosis, infective gangrene of
the muscles.
Gas Gangrene........................pptx
AETIOLOGY:
The disease is caused by
1. Clostridium perfringens ( Clostridium.welchii)-
the commonest organism (60%). Other organisms
are
2. Clostridium septicum
3.Clostridium oedematiens
4.Clostridium histolyticum.
These are gram-positive,
anaerobic spore-bearing bacilli.
SOURCE OF INFECTION:
Manured soil or cultivated soil, normal intestines.
RISK GROUP:
In patients who have had lower limb amputations
performed for ischaemic gangrene, infection
can occur from patient's own bowel organisms.
High velocity gun shot wounds with perforation
of hollow viscus are also associated with risk
of developing gas gangrene (military wound).
Immunocompromised patients are at risk.
Gas Gangrene........................pptx
Gas Gangrene........................pptx
Toxins and their effect:
Lecithinase Dermonecrosis
,Hemolysis
Beta toxins Necrosis of tissue
proteinase Breakdown of collagen fibre
Hyaluronidase Break the cement substance
of muscle cell
CLINICAL FEATURES:
 Severe pain and gross oedema of the wound.
 Sutured wound is under tension.
 Thin brownish fluid escapes which has sickly sweet odour.
 Palpable crepitus .
 Colour changes in the muscles.
 Skin becomes khaki-coloured due to haemolysis.
 Anxious and alert
 Toxic and ill
 Rapid increase in the pulse rate
 Hypotension due to suppression of adrenals
 Vomiting
 Low grade fever
DIAGNOSIS:
To examine the pus under microscope after staining
with Giemsa stain.
Presence of gas indicates anaerobic metabolism.
Anaerobic streptococci also produce gas.
PROPHYLAXIS:
1. Debridement:
2. Prophylactic antibiotics:
3. Judicious and minimal use of tourniquet:
If possible,
4. Gentle but effective application of
plaster cast
TREATMENT:
 Emergency surgery which includes excision of all
dead muscles and necrotic tissues by using generous,
long incisions-debridement.
 Penicillin to be continued.
 Blood transfusions before, during and after
surgery.
 Polyvalent anti-gas gangrene serum.
 Hyperbaric oxygen will reduce the amount of
toxin produced by the organisms (controversial).
 Do not hesitate to amputate if it saves the life,
because this is the only measure in late cases.
HOMOEOPATHIC TREATMENT:
-Arsenicum
-Crotalus
-Secale
-Carbo vegetabilis
-Lachesis mutus
-Polygonum punctatum
-Sulphuricum acidum

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Gas Gangrene........................pptx

  • 2. Gangrene refers to the death of body tissue due to either a lack of blood flow or a serious bacterial infection. Gangrene commonly affects the extremities, including your toes, fingers and limbs, but it can also occur in your muscles and internal organs.
  • 3. Types of gangrene:- 1.Dry gangrene. 2.Wet gangrene. 3.Gas gangrene. 4.Internal gangrene. 5.Fourniers gangrene.
  • 4. DEFINITION: It is a highly fatal, rapidly spreading infection caused By clostridial organisms which results in myonecrosis. Gas gangrene also known as Clostridial myositis, clostridial myonecrosis, infective gangrene of the muscles.
  • 6. AETIOLOGY: The disease is caused by 1. Clostridium perfringens ( Clostridium.welchii)- the commonest organism (60%). Other organisms are 2. Clostridium septicum 3.Clostridium oedematiens 4.Clostridium histolyticum. These are gram-positive, anaerobic spore-bearing bacilli.
  • 7. SOURCE OF INFECTION: Manured soil or cultivated soil, normal intestines.
  • 8. RISK GROUP: In patients who have had lower limb amputations performed for ischaemic gangrene, infection can occur from patient's own bowel organisms. High velocity gun shot wounds with perforation of hollow viscus are also associated with risk of developing gas gangrene (military wound). Immunocompromised patients are at risk.
  • 11. Toxins and their effect: Lecithinase Dermonecrosis ,Hemolysis Beta toxins Necrosis of tissue proteinase Breakdown of collagen fibre Hyaluronidase Break the cement substance of muscle cell
  • 12. CLINICAL FEATURES: Severe pain and gross oedema of the wound. Sutured wound is under tension. Thin brownish fluid escapes which has sickly sweet odour. Palpable crepitus . Colour changes in the muscles. Skin becomes khaki-coloured due to haemolysis. Anxious and alert Toxic and ill Rapid increase in the pulse rate Hypotension due to suppression of adrenals Vomiting Low grade fever
  • 13. DIAGNOSIS: To examine the pus under microscope after staining with Giemsa stain. Presence of gas indicates anaerobic metabolism. Anaerobic streptococci also produce gas.
  • 14. PROPHYLAXIS: 1. Debridement: 2. Prophylactic antibiotics: 3. Judicious and minimal use of tourniquet: If possible, 4. Gentle but effective application of plaster cast
  • 15. TREATMENT: Emergency surgery which includes excision of all dead muscles and necrotic tissues by using generous, long incisions-debridement. Penicillin to be continued. Blood transfusions before, during and after surgery. Polyvalent anti-gas gangrene serum. Hyperbaric oxygen will reduce the amount of toxin produced by the organisms (controversial). Do not hesitate to amputate if it saves the life, because this is the only measure in late cases.