The essence of gas gangrene and conditions of its occurrence
Gas gangrene - this anaerobic infection that develops due to extensive tissue damage
. As a rule, it causes: gunshot wounds, lacerations, bruises wounds, open fractures and detachments limbs injured colon and other serious injuries
. The larger the scale of damage to the tissues of the body and the more they are contaminated, the more favorable conditions for the development of infection
. The causative agent of gas gangrene - aerobic microbes that eat the dead cells located in the wound
. In the process of breeding these microbes secrete a specific gas
. He is not only one of the characteristic symptoms of infection, but also causes extensive intoxication of vital body systems
. As a rule, the infection develops within the first days after the injury, but in some cases the symptoms of the disease appear much later
. Note also that the diagnosis gas gangrene and must be treated as soon as possible, as the disease is extremely dangerous and often leads to death of patient
Gas gangrene - symptoms and clinical picture
Currently, doctors distinguish 4 forms of the disease of gas gangrene.
Classical gas gangrene is characterized by local swelling of damaged tissue, which gradually turns into necrosis and accompanied by intensive gas formation. The skin around the wound becomes pale, covered with brown spots. On palpation of her stand out bubbles of gas and liquid sukrovichnaya. Damaged tissues become gray-green hue and a few hours later with the release of the final die putrid smell. Classical gas gangrene is not accompanied by pus.
Edematous-toxic form of the disease gas gangrene. Around the area there is extensive damage to the swelling, which gradually expands to more healthy tissue. Pus - no, flatulence - is weak. Swelling spreads very quickly. As a consequence, necrosis of muscle tissue appears almost immediately after the injury.
Abscess gas gangrene - symptoms unlike other forms are mild. In most cases, necrosis is limited to a small area, but the process is accompanied by pus and flatulence. The temperature of the skin is not reduced, stain on the skin and swelling - no.
Putrid form of gangrene. It is developing very rapidly with intense disintegration of tissue. Muscle necrosis occurs very quickly with the office of pus and gas evolution. The rate of infection is due to a symbiosis of aerobic and putrefying bacteria. Thus the causative agent of gas gangrene produces toxins that destroy the tissues and proteins of the walls of blood vessels, which leads to the appearance of secondary erosive bleeding. There is another characteristic feature: if the previous form of the disease most often localized on the extremities, the putrid gas gangrene is mainly distributed in the mediastinum and rectum.
With regard to the common symptoms of the disease, it is possible to identify a number of the most common symptoms of gas gangrene:
- lowering blood pressure;
- depression or, conversely, too much excitement;
- increase in body temperature to 38-39 degrees;
- agonizing insomnia;
- rapid breathing;
- rapidly developing anemia.
Gas gangrene, treatment which was launched out of time, results in rapid death (within 2-3 days). Sometimes death is much faster (so-called "instant" gas gangrene). In the latter case, the person would save only urgent surgery and qualified medical care.
Gas gangrene - treatment and prevention
At the slightest suspicion of the presence of infection should begin active surgical treatment. The doctor should carry out wide opening of each damaged area and excise dead tissue. This ensures proper drainage and to drain pus wounds. Along the edges of the damaged section introduced broad-spectrum antibiotics. If you have a confirmed diagnosis of gas gangrene, treatment is immediate amputation followed by hyperbaric oxygen therapy (patient regularly placed in a chamber with a set high pressure (maximum 3 atm).
Immediately after the detection of gas gangrene patients assigned intensive fluid therapy with the use of plasma, albumin, protein and electrolyte solutions. If gas gangrene develops symptoms which indicate the occurrence of anemia, patients receive blood transfusions, while the introduction of antibiotics.
If the causative agent of gas gangrene diagnosed, doctors use monovaletnye protivogangrenoznye serum. If not, the patient is administered polyvalent serum broad spectrum of action.
With regard to general measures. Patients with a diagnosis of gas gangrene isolated from other patients. Near them are organized round the clock nursing post. All instruments and linens carefully handled. Note that the bacterial spores are killed only by repeated boiling, so better to use to disinfect the air or steam sterilization using special equipment.
Observance of safety precautions in the treatment of gas gangrene refers to health professionals. All procedures must be carried out in rubber gloves. Recent regularly disinfected. Dressings and other supplies are destroyed immediately after the ligation.