title: Gas gangrene.
abstract: Gas gangrene is not a disease of the past. Despite improved awareness, earlier care of trauma victims, new antibiotics, and advanced monitoring techniques, histotoxic clostridia continue to cause loss of life and limb. A 20-year literature review on gas gangrene (Part I) indicates that a combined therapy approach with early recognition, surgical intervention, appropriate antibiotics, and hyperbaric oxygen (HBO) provides optimal care. Part II, a 15-year clinical experience, appears to be the largest English-language series reported using the combined therapy of antibiotics, surgery, and hyperbaric oxygen. One hundred thirty-nine patients (95 males and 44 females), average age, 38 years, were admitted with clostridial myonecrosis. Sixty-seven were in shock at admission and the 27 deaths occurred in this group. One hundred twelve patients (81%) survived the infection. There was a 5% mortality in post-traumatic extremity clostridial myonecrosis. Age and concurrent disease increased the mortality rate, as did delay from time of diagnosis to aggressive combined treatment.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D003013:Clostridium / Q000502:physiology; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D005738:Gas Gangrene / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged
chemical_list: D000900:Anti-Bacterial Agents