Read more about the symptoms of gangrene and diagnosing gangrene. Anyone can develop gangrene, particularly after a serious injury, but there are certain groups of people who are more at risk. The earlier treatment for gangrene begins, the more successful it's likely to be. The main treatments include surgery to remove damaged tissue, known as debridement, and antibiotics to treat any underlying infection.
In more severe cases, it may be necessary to remove an entire body part such as a toe, foot, or lower leg. In gas gangrene, the skin may :. This is known as subcutaneous emphysema. The gas is produced by the infectious bacteria and is highly toxic, causing the necrosis to spread quickly. A doctor will carry out a physical examination and take a medical history, to find out about symptoms and potential exposure to infection or trauma.
If gangrene is suspected, further diagnostic tests will be used to determine the type and extent of the necrosis, and to detect or rule out gas gangrene. Tests of blood, tissue, and any discharge may be carried out to identify any bacterial infection.
Anyone with suspected symptoms of gangrene needs immediate medical attention, to reduce the risk of serious complication and death. The most severe form, gas gangrene, is fatal without treatment. A hyperbaric chamber of high-pressure oxygen improves oxygen supply to the wounds by encouraging the formation of new blood vessels, and by causing greater dissolution of oxygen in the plasma.
Treatment takes place in a pressure chamber, and it involves inhaling pure oxygen at 2. Side effects can include pressure-related trauma to the ears or nose and temporary near-sightedness. Supervision by a qualified professional can prevent decompression sickness and non-lethal convulsions caused by oxygen toxicity.
Measures to help people who are susceptible to gangrene reduce their risk include :. For those at risk, regular visits to a podiatrist for foot care and treatment can reduce the risk of gangrene developing. Different skin types require different skin care products. Introduction Emergency physicians and surgeons are confronted with patients of gas gangrene so uncommon in civilian practice that many are unfamiliar with its signs and symptoms and do not recognize its development quickly and accurately.
Case Report A year-old female obese farmer BMI 35 presented to the Emergency Department with a two-day history of the right leg progressing sensory deprivation and swelling. Figure 1. The limb was severe swollen and skin was brownish with bullae exuding from the incision. Figure 2.
The muscle was found to be necrotic, foul smelling, and crepitant both superficially and deep. Source Cause Age Fracture Soft tissue Pathogen Outcome Fee, [ 5 ] Fall from a tree 8 Closed, forearm A small laceration Gram-positive Spore-forming rods Lived with disarticulation Fall from a tree 10 Open, right forearm Two small lacerations Clostridium perfringens Lived with amputation Fall from a tree 11 Open, right forearm A puncture wound Clostridium perfringens Lived with amputation Fall from a roof 12 Open, right forearm Two openings Clostridium perfringens Lived with preserved forearm Fall on the street 52 Open, left radius A puncture wound Gram-positive rods Lived with amputation Buchanan and Gordon, [ 6 ] Fall from 5 stories 19 Compound fracture of right tibia and fibula Contaminated with dirt, gravel Clostridium perfringens Lived with amputation Fulford, [ 7 ] Traffic accident 19 Open, right femur Contaminated, No detail Unknown Lived with preserved limb Lucas et al.
Survived with amputation Automobile accident 21 Open, pelvic Multiple Clostridium perfringens Survived Fall from running 10 Open, both bones of forearms Mild damage of soft tissue Clostridium perfringens Survived with amputation Automobile accident 19 Open, tibia, and fibula Severe damage of soft tissue Bacillus subtilis, Proteus Survived with amputation Johnson et al.
Table 1. Table 2. Clinical outcome, pathogens, fractures locations, fractures, or surgeries types. Table 3. References W. Altemeier, W. Culbertson, M. Vetto, and W. Archives of Surgery , vol. View at: Google Scholar W. View at: Google Scholar R. Rich and R. View at: Google Scholar H. Shibuya, H. Terashi, S. Kurata et al. View at: Google Scholar N. Fee, A. Dobranski, and R. View at: Google Scholar J.
Buchanan and S. View at: Google Scholar P. Lucas, D. Speller, and M. View at: Google Scholar I. Woolley, R. Love, and A. Werry and R. Goon, M. O'Brien, and O. Taylor, T. Bramwell, and N. Mulier, M. Morgan, and G. Lorea, Y. Baeten, N. Chahidi, D. Franck, and J. Although infection after a fracture is not common, they can occur after experiencing a broken bone due to bacteria entering the body during the injury event or surgical repair.
For example, when a bone breaks through the skin or a wound opens down to the bone, bacteria can easily reach the bone and lead to infection. Your doctor will see you in the office to diagnose the infection and assess the seriousness of the situation. Treatment depends on the location of the infection and injury. You will be started on antibiotics as soon as possible in the emergency room.
Then, the wound will be cleaned during surgery and as much contamination will be removed from the skin, soft tissues and bone. If you still have an infection after surgery, you may continue antibiotics, but additional surgeries may be necessary to clean out the infection and determine the type of bacteria. Identifying the type of bacteria causing the infection will help your doctor choose the most effective antibiotics.
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