Gas Gangrene

Hey Friends, this video is about gas gangrene, how they appears and the symptoms and their diagnosis and treatment.

1. Gas Gangrene

2. Gangrene is the death of body tissue. Clostridial myonecrosis , a type of gas gangrene, is a fast-spreading and potentially life-threatening form of gangrene caused by abacterial infection from  Clostridium  bacteria. The infection causes toxins to form in the tissues, cells, and blood vessels of the body. These bacteria will release toxins that cause tissue death and release a gas. Most gangrene infections occur in situations where open wounds from an injury or surgery are exposed to bacteria. Non-traumatic gas gangrene, a more rare form of gas gangrene, can develop when blood flow to body tissues is compromised and bacteria gets inside. There is a greater risk in people who have a peripheral vascular disease, atherosclerosis, or diabetes mellitus.

3. Gas gangrene can occur anywhere on the body, but it most commonly affects the arms or legs. Common symptoms include increased heart rate, fever, and air under the skin. Skin in the affected area also becomes pale and then later changes to dark red or purple. These symptoms usually develop six to 48 hours after the initial infection and progress very quickly.

4. Etiology Clostridium  species produce more toxins and exhibit higher degrees of  virulence  than any other bacterial taxon.  Clostridium  infections are usually opportunistic, and occur in individuals with serious preexisting medical conditions Virulence factors
Members of the Clostridium species exhibit a plethora of virulence factors. Common virulence factors associated with gas gangrene include alpha toxin and theta toxin. Clostridium perfingens causes 80–90% of infections and produces both these toxins.

5. Pathophysiology

6. Symptoms A multitude of symptoms is associated with Gas gangrene. Distinctively, black lesions on the skin appear in a bubble form which allows visualization of gas-producing bacteria. Symptoms include: Skin discoloration "Foul, sweet" smelling discharge from lesions formed on skin Distinctive black, bubble lesions on skin Necrosis Fever

7. Pain following site of surgery or trauma Lightheadedness Rapid heart rate Numbness on affected site Blisters Air in subcutaneous tissues Swelling Jaundice

8. Diagnosis Various diagnostic methods can be employed in the diagnosis of Gas gangrene. Due to low incidence of myonecrosis it is an easy-to-overlook diagnosis. As bacterial infections mostly exhibit the same symptoms, early diagnosis of gas gangrene rarely occurs. The ambiguous symptoms only contribute to a poorer prognosis. Diagnostic methods include: Biopsy of affected tissue Cultures of fluids from inflicted area Magnetic resonance imaging to visualize necrotized subcutaneous tissues X-rays for air pockets in affected tissues Microscopy identification of strain of bacteria sampled from fluids of inflicted area Gram stain

9. Treatment Treatment is usually  debridement  and  excision ,   amputation  necessary in many cases. Water-soluble  antibiotics  (such as penicillin) alone are not effective because they do not penetrate  ischaemic   muscles  sufficiently to be effective. Penicillin is effective against  C. perfringens . When gas gangrene occurs in such regions as the abdominal cavity, the patient can be treated in a  hyperbaric chamber , which contains a pressurized oxygen-rich atmosphere. The oxygen saturates the infected tissues and thereby prevents the growth of the obligately anaerobic clostridia

10. Prognosis Gas gangrene left untreated is a potentially fatal infection. Early diagnosis of the type of infection and species causing the infection will improve prognosis tremendously. Preventive measures are employed universally through medical facilities to stymie bacterial infections in patients. Reducing the susceptibility of infection will promote a better prognosis by practicing good hygiene and preventing the contraction of diseases which produce hypoxia or an immunocompromised state. Following resolution of myonecrosis , patients will often require further care following the deleterious effects caused by the infection. Skin grafts are often required following removal of necrotic tissues. Former patients will still require hyperbaric oxygen therapy to prevent a recurring infection

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