Transcript Gas Gangrene

Gas Gangrene
A Presentation by Jennifer Kent-Baker
What is Gangrene?
Gangrene is necrosis and subsequent decay of
body tissues caused by infection or thrombosis or
lack of blood flow. It is usually the result of
critically insufficient blood supply sometimes
caused by injury and subsequent contamination
with bacteria. This condition is most common in
the extremities. The best of all possible treatments
is revascularization of the affected organ, which
can reverse some of the effects of necrosis and
allow healing.
What is Gas Gangrene?
Gas gangrene is a severe form of gangrene
usually caused by Clostridium perfringens. It
can also be from Group A Streptococcus.
Staphylococcus aureus and Vibrio vulnificus can
cause similar infections.
Risk Factors
Trauma or recent surgical wound
 Arthrosclerosis
 Diabetes
 Colon Cancer
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Onset
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The onset of gas gangrene is sudden and dramatic.
Inflammation begins at the site of infection as a pale-tobrownish-red and extremely painful tissue swelling. Gas
may be felt in the tissue as a crackly sensation when the
swollen area is pressed with the fingers. The edges of the
infected area expand so rapidly that changes are visible over
a few minutes. The involved tissue is completely destroyed.
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Clostridium bacteria produce many different toxins, four of
which can cause potentially fatal syndromes. In addition,
they cause necrosis, hemolysis, vasoconstriction, and
increased vascular permeability.
Signs and Symptoms
Symptoms usually begin suddenly
and rapidly worsen.
 Moderate to severe pain around a skin injury
 Progressive swelling around a skin injury
 Moderate to high fever
Initial pallor, later dusky progressing to dark
red or purple
 Vesicle formation
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Signs and Symptoms, cont.
 Blisters
filled with brown-red fluid
 Drainage from the tissues, foul-smelling
serosanguineous discharge
 Tachycardia
 Diaphoresis
 Subcutaneous emphysema
Gas Gangrene Illustrated
Diagnostics
“Cat” Scan
Gram stain of fluid from the
infected area
Culture
Blood cultures
Anaerobic tissue and/or fluid
culture
MRI
X-Ray
Medical Management
Establish a larger wound opening to admit
air and promote drainage
 Antibiotics via IV
 Wound debridement
 Amputation
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Nursing Interventions
Wound care with strict medical asepsis
Autoclaving of equipment and linens
Drainage and secretion isolation
Medications
Antibiotics
Analgesics
Hyperbaric oxygen
Complications
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Disfiguring or disabling permanent tissue damage
Jaundice with liver damage
Kidney failure
Sepsis
Shock
Stupor
Delirium
Coma
Death (That is a complication, isn’t it?)
Prognosis
Gas gangrene is progressive
and often lethal.
Immediate medical attention
is required.