Gas Gangrene

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Clostridial myositis and myonecrosis

The condition literally threatens both life and limb. Gas gangrene usually involves only the muscle. In moist or gas gangrene, there is a sensation of heaviness in the affected region that is followed by severe pain. Swelling resulting from fluid or gas accumulation in the tissues causes the pain. This pain peaks, on average, between one to four days following the injury, with a range of eight hours to several weeks. The swollen skin may initially be blistered, red, and warm to the touch before progressing to a bronze, brown, or black color. In approximately 80% of cases, the affected and surrounding tissues may produce crackling sounds (crepitus), as a result of gas bubbles accumulating under the skin. The gas may be felt beneath the skin (palpable).

Symptoms include fever, rapid heart rate, rapid breathing, altered mental state, loss of appetite, diarrhea, vomiting, and vascular collapse may also occur if the bacterial toxins are allowed to spread in the bloodstream. In gas gangrene there is a “sweet” smelling watery discharge.

For best results, hyperbaric oxygen therapy should be administered immediately following the required surgery. The theory behind using hyperbaric oxygen therapy 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 is 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 therapy produces marked pain relief, reduces the number of amputations required, and reduces the extent of surgical debridement required.

Hyperbaric oxygen therapy treatment works to decrease the production of the alpha toxin released from clostridium — bacteria found in soil — limit the spread of bacteria and oxygenate tissues.

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