Diagnosis and treatment of gas gangrene in 8 transferred patients after China Wenchuan earthquake / 中华创伤杂志

ABSTRACT

Objective To analyze clinical manifestation,diagnosis and treatment of 8 patients with gas gangrene in Wenchuan earthquake.Methods Eight patients with gas gangrene in Wenchuan earthquake were selected for analysis on their clinical manifestations.We finally diagnosed gas gangrene based on patients'clinical manifestation and the cultured ciostridium in the focus of infection.All the patients were treated with antibiotics,repeated surgical debridement,hyperbaric oxygen and nutritional support.Results Most patients had no erepitation of the extremities but found gas in interstice of tissues identified by X-ray,B-ultrasound and CT scanning.Film preparation of efflusion of all patients showed clostridium and bacterial culture manifested mainly perfringens.Most patients were demonstrated to be with polyinfection.In addition,all patients were characterized by pitchy necrotic tissues,effusion,systemic decrease of red blood cells,increase of white blood cells and platelet.No death or amputation occurred under active combined therapy.Conciusions Earthquake induces mainly open trauma often combined with mixed infection,when gas gangrene is one of main special infections.The predominant combined therapies include utility of antibiotics and thorough surgical debridement,while hyperbaric oxygen and nutritional support are important and effective adjunctive therapies.