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Gas gangrene is a form of gangrene (tissue death) usually caused by a bacterium known as clostridium porringers, but many other bacteria can cause the same effects. It is caused by an infection of clostridium bacteria that, under low oxygen conditions, produce toxins that cause the tissue death and associated symptoms. Gas gangrene is rare, with only 1, 000 to 3, 000 cases occurring in the United States annually. Gas gangrene usually occurs at the site of trauma or a recent surgical wound. About a third of cases occur spontaneously. Patients who develop this disease spontaneously often have underlying another disease such as diabetes or colon cancer.
The onset of gas gangrene is sudden and dramatic. Inflammation begins at the site of infection and there is extremely painful tissue swelling. Gas may be felt in the tissue when the swollen area is pressed with the fingers. The areas infected expand so rapidly that changes are visible over a few minutes. The involved tissue is completely destroyed.
Clostridium bacteria make many different toxins, some of which can cause potentially fatal syndromes. In addition, they cause tissue death, destruction of blood, and leaking of the blood vessels. The symptoms of gas gangrene include moderate to severe pain around a skin injury, progressive swelling around a skin injury, and moderate to high fever. Also, when a person is infected, they form small, fluid filled blisters called vesicles.
The blisters fill with a brown red fluid. Some symptoms are not so serious, such as sweating and an increased heart rate. Others are very serious like drainage from the tissues, foul-smelling brown-red or bloody fluid called sero sanguineous discharge, and subcutaneous emphysema which is gas under the skin. The symptoms of gas gangrene occur suddenly and increase rapidly.
Treatment for gas gangrene can sometimes be drastic. Gas gangrene is a medical emergency because of the threat of the infection rapidly spreading via the bloodstream and infecting vital organs. It requires immediate surgery and administration of antibiotics. Prompt surgical removal of dead, damaged, and infected tissue is necessary. Amputation of an arm or leg may be indicated to control the spread of infection.
There is also another form of treatment for this disease. Although still controversial, some cases of gangrene are treated by administering oxygen under pressure greater than that of the atmosphere (hyperbaric) to the patient in a specially designed chamber. The theory behind using hyperbaric oxygen is that more oxygen will become dissolved in the patient's bloodstream, and therefore, more oxygen will be delivered to the gangrenous areas. By providing optimal oxygenation, the body's ability to fight off the bacterial infection are believed to be improved, and there is a direct toxic effect on the bacteria that thrive in an oxygen-free environment. Some studies have shown that the use of hyperbaric oxygen produces marked pain relief, reduces the number of amputations required, and reduces the extent of surgical debridement required.
Patients receiving hyperbaric oxygen treatments must be monitored closely for evidence of oxygen toxicity. Symptoms of oxygen toxicity can include slow heart rate, profuse sweating, ringing in the ears, shortness of breath, nausea and vomiting, twitching of the lips, cheeks, eyelids, and nose, and convulsions. If not detected and treated quickly, gas gangrene has a 20 - 25 % mortality rate. If recognized and treated early, however, approximately 80 % of those with gas gangrene survive, and only 15 - 20 % require any form of amputation. There are ways to prevent being infected with gas gangrene. Someone with any skin injury should clean it thoroughly.
They should also watch for signs of infection (such as redness, pain, drainage, or swelling around a wound), and consult their health care provider promptly if these occur. Because gas gangrene usually affects people with diabetes or arteriosclerosis someone with one of these diseases should take particular care of their hands and feet because of the risk of infection associated with even a minor injury. Any abrasion, break in the skin, or infection tissue should be cared for immediately. Any dying or infected skin must be removed promptly to prevent the spread of bacteria.
Penetrating abdominal wounds should be surgically explored and drained, any tears in the intestinal walls closed, and antibiotic treatment begun early. Patients undergoing elective intestinal surgery should receive preventive antibiotic therapy. Use of antibiotics prior to and directly following surgery has been shown to significantly reduce the rate of infection from 20 - 30 % to 4 - 8 %. In conclusion, it is clear that gas gangrene is a serious disease. It can be treated, but if it goes untreated for too long, it can lead to the need for an amputation and even death.
The disease is quite rare, but anyone who gets a wound should receive medical attention if the symptoms of gas gangrene are apparent. ' Bibliography web web gangrene. htm~right
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