Gas gangrene: pathogens, causes, symptoms and treatment
Gas gangrene is a complex surgical pathology, which consists in the development of an anaerobic infection in the wound, which causes massive tissue necrosis. It has a toxic effect on the body and even with intensive treatment can lead to death. The name defines the nature of the pathology - the presence of pathogens in the wound is accompanied by the formation of gas in large quantities, it remains in the form of bubbles in the tissues.
The main causative agents of pathology are bacteria belonging to the genus Clostridium. These are anaerobic organisms that can easily exist in anoxic conditions. They live in street dust, wastewater, soil, animal faeces, that is, everywhere where there is an opportunity to get from the intestines of an animal or person. Clostridium stable in the environment due to the formation of a protective capsule that allows you to maintain viability for a long time. So, they can survive when exposed to low or high temperatures, ultraviolet radiation, chemicals.
Causes of Gangrene
Wounds infected with clostridia cause gangrene. But for this to happen, access to the wound should be blocked arterial blood and oxygen. Such injuries are usually caused by sharp objects (awl, knife, nail), which penetrate deep into tissues, but do not touch large blood vessels and do not cause extensive bleeding. Indeed, during the outflow of blood in large quantities, there is a natural cleansing of the wound from any microorganisms. Also, favorable conditions for the intensive reproduction of bacteria are created in the presence of an extensive laceration with fascial pockets and tissue areas lacking blood supply. Most often such injuries occur in the lower extremities. Fall into the wound of clostridia in most cases from the ground.
Gas gangrene: symptoms
With the development of pathology in the tissues surrounding the wound, large quantities of hydrogen and carbon dioxide are collected. As a result, the tissues swell, which is why the edges of the wound move apart in different directions. If a bandage is applied to the affected area, the victim may feel pressure.If the skin in the wound area is pressed down, a sensation of bursting gas bubbles will appear. The affected area becomes dry, becomes gray, there are no signs of inflammation, but the tissues die off rapidly. Around the wound, the skin turns pale as necrosis develops, and dark spots form on it. The general condition of the patient is sharply worsening: the temperature is rapidly rising, the pulse is rising, the blood pressure drops, breathing becomes shallow, frequent, there is a strong thirst. Gas gangrene, depending on the prevailing symptoms, is divided into several forms. It can be edematous, emphysematous, phlegmonous, necrotic, tissue-melting.
Gas gangrene: treatment
To a greater extent, the outcome of treatment depends on the speed of delivery of the victim to the hospital. The infection is contagious, so the patient must be in a separate ward. In order to provide access to the wound of oxygen that kills clostridia, it should be opened as widely as possible. To do this, the fascial case is opened, lampas cuts are made along the muscle fibers to the bone, dissected and dead tissue is dissected, the wound is disinfected, drainage and loose tamponade with a solution of potassium permanganate or hydrogen peroxide are installed.Intravenous injected diluted with saline antigangrenous serum. If gas gangrene leads to rapid necrosis and a sharp deterioration in the patient’s condition, there is nothing left but to do an amputation. Such an operation is performed only if it is impossible to save the sick life in any other way.