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Gas gangrene 8 - 2- 16
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.
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Overview of gas gangrene and presenter information.
Defines gangrene as localized cell death due to obstructed blood circulation with infection.
Explains gas gangrene caused by Clostridium perfringens, impacting skeletal muscle.
Lists sources of infection including contaminated soil, fecal flora, and specific wounds.
Describes organisms responsible for gas gangrene, mainly Clostridium species.
Details types of toxins produced by Clostridium that contribute to disease severity.
Highlights various exotoxins such as lecithinase and haemolysin produced by the pathogens.
Describes effects like anaerobic myositis and extensive tissue damage from gas production.
Lists features like incubation period, symptoms including fever and specific discharge odor.
Identifies various clinical types of gas gangrene for better diagnostic understanding.
Outlines methods used in diagnosis such as imaging and laboratory tests.
Highlights complications like organ failures and the risk of death in severe cases.
Discusses treatment options including antibiotics, surgery, and supportive measures.
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Gas gangrene 8 - 2- 16
- 1. GAS GANGRENE DR.R.DURAI MS ASSISTANTPROFESSOR DEPT. OF GENERAL SURGERY MGMCRI
- 2. What is aGangrene? localized cell death by obstructed circulation with superadded bacterial infection. 2 08-02-2016GAS GANGRENE BY DR.R.DURAI MGMCRI
- 3. What is aGas Gangrene? Gangrene produced gas producing organisms like Clostridium perfringens(welchii) Oedematous myonecrosis – Skeletal muscle Malignant edema 3 08-02-2016GAS GANGRENE BY DR.R.DURAI MGMCRI
- 4. 4 08-02- 2016 GAS GANGRENE BYDR.R.DURAI MGMCRI
- 5. Source of Infection Contaminated, manured or cultivated soil, intestines Faecal flora Crush wounds War wounds Anaerobic environment 5 08-02-2016GAS GANGRENE BY DR.R.DURAI MGMCRI
- 6. Organisms Clostridium welchii(perfringens): Gram-positive, central spore bearing, nonmotile, capsulated organisms Clostridium oedematiens. Clostridium septicum. Clostridium histolyticum. 6 08-02-2016GAS GANGRENE BY DR.R.DURAI MGMCRI
- 7. 7 08-02-2016GAS GANGRENE BYDR.R.DURAI MGMCRI
- 8. TOXINS Alpha (mostcommon) Beta Epsilon Iota Phi toxin—myocardial depressant Kappa toxin—destruction of connective tissue and blood vessels Bursting factor and circulating factor 8 08-02-2016GAS GANGRENE BY DR.R.DURAI MGMCRI
- 9. EXOTOXINS Lecithinase Haemolysin Hyaluronidase Proteinase 9 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 10 08-02-2016GAS GANGRENE BY DR.R.DURAI MGMCRI
- 11. Clinical Features Incubationperiod is 1-2 days Toxaemia Fever Tachycardia Pallor 11 GAS GANGRENE BY DR.R.DURAI MGMCRI 08-02-2016
- 12. Contd… Wound isunder 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. 12 08-02-2016GAS GANGRENE BY DR.R.DURAI MGMCRI
- 13. Clinical Types Fulminanttype Massive type Group type Single muscle type Subcutaneous type 13 08-02-2016GAS GANGRENE BY DR.R.DURAI MGMCRI
- 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. 14 08-02-2016GAS GANGRENE BY DR.R.DURAI MGMCRI
- 15. Complications Septicaemia, toxaemia. Renal failure, liver failure. Circulatory failure, DIC, secondary infection. Death occurs in critically ill patients. 15 08-02-2016GAS GANGRENE BY DR.R.DURAI MGMCRI
- 16. Treatment Injection benzylpenicillin 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 16 08-02-2016GAS GANGRENE BY DR.R.DURAI MGMCRI
- 17. Contd… Radical WoundDebridement Rehydration Amputation Ventilator support Fumigation of theatre after treatment 17 08-02-2016GAS GANGRENE BY DR.R.DURAI MGMCRI
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