Prevention and Treatment of Gas Gangrene

Myonecrotic Gas Gangrene of the Extremities

“…Not all cases are caused by Clostridium perfringens and not all involve the muscles diffusely (Altemeier & Fullen 1971, Hedstrom 1975. However, every suspicion of gas gangrene should lead to institution of treatment which should always, as the first measure, include anaerobic and aerobic culturing of tissue from the affected area and not merely smears.…”

“…Most materials available are concerned with the treatment of gas gangrene as one entity and do not distinquish between different groups or affections, though it has been shown that the localised form and the cellulitis form are mild infections compared to the m yonecrot ic gangrene (Altemeier & Fullen 1971, Darke et al 1977. Infections limited to the extremities run a milder course than if,the trunk is involved (Holland et al 1975).…”

“…Only 23 of these cases were definitively spreading or diffuse myonecrotic gangrene caused by Clostridium perfringens bacteria, defined by Altemeier & Fullen (1971) as a rapidly progressive infection of the muscles in which the connective tissue may be affected to a lesser degree at first. Several compartments are involved in the process.…”

“…Not everyone, however, is convinced on this point and some claim that the effect of hyperbaric oxygen is doubtful and that early and adequate surgical measures are still of utmost importance (Altemeier & Fullen 1971, Darke et al 1977. Another purpose of this paper is to discuss the possible influence that age, vascular status and toxic condition might have on the outcome of the infection and on the basis of the literature to discuss the beneficial effect of hyperbaric oxygen therapy.…”

“…Myonecrotic infection is the most serious (Altemeier & Fullen 1971) and the purpose of this study is to describe the treatment of this entity in the extremities, which so far has not been dealt with specifically in the Scandinavian literature. Since the publication of Brummelkamp et al (1961) hyperbaric oxygen therapy has found its place in the treatment of gas gangrene and most authors have agreed that this has contributed to a more favourable course of the infection (Brummelkamp et al 1963, Trippel et al 1967, Roding et al 1972, Hommelgaard & Kolind-Serensen 1974, Holland et al 1975, Hedstrom 1975, Krebs & Jensen 1981).…”