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Oakley (1954)
Synonym
-Malignant edema
-Clostridial Myonecrosis
The rapid spreading infective gangrene of the muscles
characterized by collection of gas in the muscles and
subcutaneous tissue is called as “Gas gangrene”.
Causative factors :
Predisposing Factors :-
i) Haemorrhage and blood clot by supplying calcium.
ii)Contamination of wound with soil supplies silica and calcium.
iii)
Laceration and crush injuries of the tissues are essential, as the
organisms cannot multiply in healthy living tissue.
iv) Inadequate drainage and exudation in the muscle fibers help in
the spread of infection.
v) Diabetes and other occlusive arterial diseases
Bacteriology
Gas gangere is mainly caused by anarobic Clostridial
organisums of which cl.welchii is main organisum.
Others are- -Cl. Oedematiens.
- Cl. Septicum.
- Cl. Histolyticum.
- Cl. Bifermentas.
B) Collagenase-
is a proteinase and breaks down collagen,connective tissue
elements of the muscle.
Spreads very rapidly even beyond the limb often associated with toxaemia.
CLINICAL FEATURES
1) General –
i) Anxious and anemic look of the patient.
ii) May increase in temp.
iii) Rapid pulse, B.P. falls.
iv) Vomiting.
v) Patient remain may normal.
2) Local – i) Pain in affected limb.
ii) Gradual swellilng and gross oedema of the part.
iii) Profuse brownish and foul smelling fluid between
the sutures.
iv) Skin becomes greenish due to haemolysis.
v) Crepitus is always present due to gas in muscle
and subcutaneous tissues.
vi) Colour of muscle becomes green to black
(if visible).
Investigation
I) Prophylaxis
1) Excision or debridement of wound.
2) inj. penicillin 2 gm (4 hrly).
3) Passive Immunization :-
- Inj. Of Anti gas gangrene serum (A.G.S.) 22500