Gas gangrene
The essence of gas gangrene and the prerequisites for its occurrence
Gas gangrene is an anaerobic infection that results from extensive tissue damage. As a rule, it is caused by: gunshot wounds, lacerated and bruised wounds, open fractures and avulsion of extremities, wounds of the large intestine, and other severe injuries. The greater the extent of damage to body tissues and the more contaminated they are, the more favorable the conditions for the development of infection. The causative agent of gas gangrene is anaerobic microbes that feed on dead cells in the wound. In the process of reproduction, these microbes release a specific gas. It is not only one of the characteristic symptoms of infection, but also causes extensive intoxication of the vital systems of the body. As a rule, the infection develops within the first 24 hours after the injury, but in some cases the signs of the disease appear much later. We also note that when diagnosed with gas gangrene, treatment should be carried out as soon as possible, since the disease is extremely dangerous and often leads to the death of the patient.
Gas gangrene - symptoms and clinical picture
Currently, doctors distinguish 4 forms of gas gangrene disease.
Classic gas gangrene is characterized by local edema of damaged tissues, which gradually turns into necrosis and is accompanied by intense gas formation. The skin around the wound becomes pale, covered with brown spots. On palpation, gas bubbles and blood fluid are released from it. The damaged tissues acquire a gray-green hue and after a few hours they finally die off with the release of a cadaverous smell. Classic gas gangrene is not accompanied by pus.
Edematous-toxic form of the disease of gas gangrene. Extensive edema appears around the damaged area, which gradually expands to still healthy tissues. Pus - no, gas formation - weak. The edema spreads very quickly. As a result, muscle tissue necrosis manifests itself almost immediately after injury.
Phlegmonous gas gangrene - symptoms, unlike other forms, are poorly expressed. In most cases, tissue necrosis is limited to a small area, but the process itself is accompanied by the release of pus and gas formation. The temperature of the skin does not decrease, there are no spots on the skin and edema.
Putrid form of gangrene. It develops very rapidly with intensive tissue decay. Muscle death occurs extremely quickly with the separation of purulent contents and the release of gas. The rate of development of infection is explained by the symbiosis of anaerobic and putrefactive bacteria. In this case, the causative agent of gas gangrene releases toxins that destroy proteins of tissues and walls of blood vessels, which entails the appearance of secondary erosive bleeding. There is another characteristic feature: if the previous forms of the disease are most often localized on the limbs, then putrefactive gas gangrene mainly spreads in the mediastinal and rectal regions.
As for the general symptoms of the disease, a number of the most typical signs of gas gangrene can be distinguished:
- lowering blood pressure;
- depression or, conversely, too strong arousal;
- tachycardia;
- an increase in body temperature up to 38-39 degrees;
- excruciating insomnia;
- dehydration;
- rapid breathing;
- rapidly developing anemia.
Gas gangrene, the treatment of which was started out of time, leads to a rapid death (within 2-3 days). Sometimes death occurs much faster (the so-called "instantaneous" gas gangrene). In the latter case, only urgent surgical intervention and qualified medical care will save a person.
Gas gangrene - treatment and prevention
At the slightest suspicion of infection, active surgical treatment should be initiated. The physician should perform a wide dissection of each damaged area and excise the dead tissue. At the same time, proper drainage is also ensured to drain the purulent contents of the wound. Broad-spectrum antibiotics are administered along the edges of the damaged area. If there is a confirmed diagnosis of gas gangrene, treatment consists in immediate amputation of the limb, followed by hyperbaric oxygenation (the patient is regularly placed in a chamber with a set high pressure (no more than 3 atm).
Immediately after the detection of gas gangrene, the patient is prescribed intensive infusion therapy using plasma, albumin, proteins and electrolyte solutions. If gas gangrene develops, the symptoms of which indicate the appearance of anemia, the patient undergoes a blood transfusion with the simultaneous administration of antibiotics.
If the causative agent of gas gangrene is identified, doctors use monovalent anti-gangrenous sera. If not, then patients are injected with polyvalent serums of a wide spectrum of action.
With regard to general activities. Patients diagnosed with gas gangrene are isolated from other patients. A round-the-clock nursing post is organized near them. All tools and linens are carefully handled. Note that bacterial spores are killed only by repeated boiling, so for disinfection it is better to use air or steam sterilization using special equipment.
Compliance with the precautionary rules in the treatment of gas gangrene also applies to medical professionals. They must carry out all procedures in rubber gloves. The latter are regularly disinfected. Dressings and other consumables are destroyed immediately after the end of the dressing.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
