2. • It is a rapidly progressive, potentially fatal condition
characterized by widespread necrosis of the
muscles and subsequent soft-tissue destruction.
• This is a dreaded consequence of inadequately
treated missile wounds, crushing injuries and high-
voltage electrical injuries.
4. • They are present in the soil
and have also been
isolated from the human
gastrointestinal tract and
female genital tract.
• Non-clostridial gas-
producing organisms such
as coliforms have also
been isolated in 60–85% of
cases of gas gangrene.
6. Pathogenesis
- Bacteria
enters the
broken skin or
wound
- Spores are
produced
- The bacteria
present in
circulation
system
the anaerobic
tissue present
- The bacteria are
grow and ferment
the muscle
carbohydrate
- The toxins
(lecithinase)
and enzyme
are produced
Examples of enzyme:
colagenases, proteases
and lipases
- These enzymes will
kill other host cell and
extend the anaerobic
environment
- Produce gases (nitrogen,
hydrogen sulphide and
carbon dioxide)
- Crepitant tissue
( destroyed tissue)
7. Epidemiology
– The persons at risk those with Diabetes Mellitus,
blood vessel disease and colon cancer
– Contact with contaminated cloth and other
foreign material
– Trauma or recent surgical wound
8.
9. Symptoms
• High fever
• Shock
• Massive tissue destruction
• Blackening of skin
• Severe pain around a skin of wound
• Blisters with gas bubbles form near the
infected area,
• the heartbeat and breathing become
rapid.
10. Crepitation in tissues,
sickly sweet odor discharge,
rapidly progressing necrosis,
fever, hemolysis, toxemia,
shock,
renal failure, and death
Presentation
18. Prevention
• Cleaning the wound
• Avoid the contaminated material
• improve circulation in
patients with poor circulation
• antitoxin
19. (1) Do a thorough wound toilet.
(2) In high risk wounds give the patient
penicillin 1.5 megaunits 4 hourly,
or tetracycline
Prevention
20. Treatment
• High doses of antibiotic : Penicillin
• The dead tissue is removed or limbs are
amputated
• No vaccine
21. 10 megaunits of benzyl penicillin daily for 5
days as four 6 hourly doses.
Or
Tetracycline 0.5 g intravenously
or 1 g orally every 6 hours.
Clostridia not sensitive to metronidazole,
some other anaerobic bacteria are, so give
it.
22. Do this in a septic theatre,
or even in the out-patient department,
and not where clean cases go for operation.
EXPLORATION
28. • Patients should be admitted to ICU and
treated aggressively with careful monitoring.
• The role of HBO is not as clear as in
necrotising fasciitis but it is recommended in
severe cases if the facilities are available.
– increases the normal oxygen saturation in the
infected wounds by 1000-fold leading to
• Bacteriocidal effect,
• Improves neutrophil function,
• Enhanced wound healing
