Gangrene refers to a condition described as tissue death. Derived from word ‘gangraena’ which in Latin refers to ‘eating sore,’ this condition first came into recognized during World War. This condition occurs when an open wound gets contaminated by Clostridium Perfringes bacterium. Normally, production of gas also accompanies gangrene and is referred to as called Gas gangrene. This is a form of wet gangrene and is far more serious than the dry type of gangrene.
What is Gas Gangrene?
Clostridium perfringes is a gram positive, rod shaped anaerobic bacterium. It normally inhabits the soil and the intestines of the humans and animals. It is the most common etiological agent for gas gangrene. Hence, gas gangrene is also called as Clostridial myonecrosis. It spreads fast and is life threatening. In addition, it is caused by other Clostridium species and by both, group A Streptococci and Staphylococcus aureus.
Gas gangrene can occur anywhere on the body, but most commonly it affects the arms and the legs. The infection occurs when wounds caused due to surgery or injury gets exposed to these bacteria. The anaerobic conditions in the body allow this bacterium to grow and release exotoxins which act on the cells, tissues and blood vessels and cause their destruction. It affects the oxygen distribution to the part of the body since it leads to destruction of blood vessels and leads to gas formation. Thus, gas gangrene causes muscle tissue death (or myconecrosis), gas production and sepsis.
Symptoms of Gas Gangrene
The symptoms develop within 6 to 48 hours after infection. The symptoms of gas gangrene include:
- The affected wound area is inflamed and appears as swollen along with pain.
- The affected skin becomes pale and has black blisters which have offensive smell.
- Gas production under skin
- Increased heart rate
All these symptoms of gas gangrene develop quickly to cause tissue death.
Risk Factors of Gas Gangrene
Certain injuries have a high risk of causing gas gangrene. These include:
- Injuries of the muscle
- Deep wounds
- Wounds contaminated with soil or stools of farm animals
- Frost bites
- Open fractures
Diagnosis of Gas Gangrene
The doctor performs physical examination and suggests various diagnostic tests like:
- Bacterial culture to detect the presence of Clostridium perfringes or other causative agents
- Blood tests
- X-ray to visualize tissues and detect the presence of gas
- MRI scan.
Treatment of Gas Gangrene
The treatment of gas gangrene should be started immediately. The initial treatment for gas gangrene is with high dose of antibiotics. Clindamycin, rifampin, metronidazole and penicillin are some of the effective antibiotics.
Surgery is performed to remove the dead tissue. At times it can also involve amputation of the affected body part. After the wound heals, a prosthetic limb is fitted to replace the missing body part.
Hyperbaric treatment is also used in the treatment for gas gangrene. This therapy involves breathing pure oxygen in a pressurized chamber for 90 minutes. One needs to inhale oxygen two to three times per day. The increase in the amount of oxygen in the body, stops the growth of anaerobic bacteria and helps in rapid wound healing. The blood flow to lower extremities can be improved with Angioplasty; while, therapeutic angiogenesis allow growth of new blood vessels.
Prevention of Gas Gangrene
The ways to prevent the occurrence of gas gangrene involves:
- Use of sterile instruments during surgery for treatment of the soldiers on warfront
- Taking care of the open wounds and maintain hygiene
- One should have healthy diet
- Avoid smoking and drinking
- Controlling of blood sugar is necessary. Besides, any wounds especially foot lesions, should be treated immediately.
Complications of Gas Gangrene
One should not delay the treatment as the symptoms develop rapidly. If neglected, gas gangrene can lead to:
- Permanent tissue damage
- Liver damage
- Kidney failure
- Death due to infection.
- It becomes a life threatening condition within 48 hours of the onset of the symptoms.
Gas gangrene still exists and needs urgent attention since it carries a very high mortality rate. The mortality rate increases in individuals with spontaneous gas gangrene and in whom treatment is delayed.
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