Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Gas Gangrene: Review of 34 Cases

Gas Gangrene: Review of 34 Cases Abstract High morbidity and mortality continue to result from gas gangrene, despite the use of aggressive modes of therapy. Between 1967 and 1973, 34 patients with gas gangrene were seen at the University of Maryland Hospital; 11 (32.3%) died. Clostridium perfringens was recovered from the wounds in 79% of the cases and from the blood in 15%. Eighty-five percent of the wounds contained one or more organisms in addition to C perfringens, with as many as seven organisms recovered from some wounds. Twenty-nine patients received hyperbaric oxygen treatments, as well as the more conventional antibiotic drugs; it was not possible to assess the value of this added therapy. Gangrene of the abdominal wall resulted in a higher (50%) mortality than gangrene of an extremity (24%). Presence of normal or depressed white blood cell counts, decreased platelet counts, and abnormal renal or liver functions all denoted a poor prognosis. (Arch Intern Med 136:788-791, 1976) References 1. Altemeier WA, Fullen WD: Prevention and treatment of gas gangrene . JAMA 217:806-813, 1971.Crossref 2. Hitchcock CR, Haglin JJ, Arnar O: Treatment of clostridial infections with hyperbaric oxygen . Surgery 62:759-769, 1967. 3. Altemeier WA, Culbertson WR, Vetto M, et al: Problems in the diagnosis and treatment of gas gangrene . Arch Surg 74:839-845, 1957.Crossref 4. Weinstein L, Barza MA: Current concepts: Gas gangrene . N Engl J Med 289:1129-1131, 1973.Crossref 5. Colwill MR, Maudsley RH: The management of gas gangrene with hyperbaric oxygen therapy . J Bone Joint Surg 50( (B) ):732-742, 1968. 6. Isenberg AN: Clostridium welchii infection . Arch Surg 92:727-731, 1966.Crossref 7. Pappas AM, Filler RM, Eraklis AJ, et al: Clostridial infections (gas gangrene) . Clin Orthop 76:177-184, 1971.Crossref 8. Demello FJ, Haglin JJ, Hitchcock CR: Comparative study of experimental Clostridium perfringens infection in dogs treated with antibiotics: Surgery and hyperbaric oxygen . Surgery 73:936-941, 1973. 9. Eraklis AJ, Filler RM, Pappas AM, et al: Evaluation of hyperbaric oxygen as an adjunct in the treatment of anaerobic infections . Am J Surg 117:485-492, 1969.Crossref 10. Glover JL, Mendelson J, Heitkamp DH: Effects of hyperbaric oxygenation on rabbits with Clostridium perfringens infection . J Trau ma 4:642-651, 1964.Crossref 11. Schweigel JF, Shim SS: A comparison of the treatment of gas gangrene with and without hyperbaric oxygen . Surg Gynecol Obstet 136:969-970, 1973. 12. Parker MT: Postoperative clostridial infections in Britain . Br Med J 3:671-676, 1969.Crossref 13. Duff JH, McLean PH, McLean LD: Treatment of severe anaerobic infections . Arch Surg 101:314-317, 1970.Crossref 14. Trippel OH, Ruggie AN, Staley CJ, et al: Hyperbaric oxygenation in the management of gas gangrene . Surg Clin North Am 47:17-27, 1967. 15. Lulu DJ, Rivera FJ: Gas gangrene . Am Surg 36:528-532, 1970. 16. Roding D, Groeneveld PHA, Boerema I: Ten years of experience in the treatment of gas gangrene with hyperbaric oxygen . Surg Gynecol Obstet 134:579-585, 1972. 17. Davis JC, Dunn JM, Hagood CO, et al: Hyperbaric medicine in the US Air Force . JAMA 224:205-209, 1973.Crossref 18. Brummelkamp WH: Considerations on hyperbaric oxygen therapy at three atmospheres absolute for clostridial infections type welchii . Ann NY Acad Sci 117:688-699, 1965.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Gas Gangrene: Review of 34 Cases

Loading next page...
 
/lp/american-medical-association/gas-gangrene-review-of-34-cases-YtBt0jbreX
Publisher
American Medical Association
Copyright
Copyright © 1976 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1976.03630070036011
Publisher site
See Article on Publisher Site

Abstract

Abstract High morbidity and mortality continue to result from gas gangrene, despite the use of aggressive modes of therapy. Between 1967 and 1973, 34 patients with gas gangrene were seen at the University of Maryland Hospital; 11 (32.3%) died. Clostridium perfringens was recovered from the wounds in 79% of the cases and from the blood in 15%. Eighty-five percent of the wounds contained one or more organisms in addition to C perfringens, with as many as seven organisms recovered from some wounds. Twenty-nine patients received hyperbaric oxygen treatments, as well as the more conventional antibiotic drugs; it was not possible to assess the value of this added therapy. Gangrene of the abdominal wall resulted in a higher (50%) mortality than gangrene of an extremity (24%). Presence of normal or depressed white blood cell counts, decreased platelet counts, and abnormal renal or liver functions all denoted a poor prognosis. (Arch Intern Med 136:788-791, 1976) References 1. Altemeier WA, Fullen WD: Prevention and treatment of gas gangrene . JAMA 217:806-813, 1971.Crossref 2. Hitchcock CR, Haglin JJ, Arnar O: Treatment of clostridial infections with hyperbaric oxygen . Surgery 62:759-769, 1967. 3. Altemeier WA, Culbertson WR, Vetto M, et al: Problems in the diagnosis and treatment of gas gangrene . Arch Surg 74:839-845, 1957.Crossref 4. Weinstein L, Barza MA: Current concepts: Gas gangrene . N Engl J Med 289:1129-1131, 1973.Crossref 5. Colwill MR, Maudsley RH: The management of gas gangrene with hyperbaric oxygen therapy . J Bone Joint Surg 50( (B) ):732-742, 1968. 6. Isenberg AN: Clostridium welchii infection . Arch Surg 92:727-731, 1966.Crossref 7. Pappas AM, Filler RM, Eraklis AJ, et al: Clostridial infections (gas gangrene) . Clin Orthop 76:177-184, 1971.Crossref 8. Demello FJ, Haglin JJ, Hitchcock CR: Comparative study of experimental Clostridium perfringens infection in dogs treated with antibiotics: Surgery and hyperbaric oxygen . Surgery 73:936-941, 1973. 9. Eraklis AJ, Filler RM, Pappas AM, et al: Evaluation of hyperbaric oxygen as an adjunct in the treatment of anaerobic infections . Am J Surg 117:485-492, 1969.Crossref 10. Glover JL, Mendelson J, Heitkamp DH: Effects of hyperbaric oxygenation on rabbits with Clostridium perfringens infection . J Trau ma 4:642-651, 1964.Crossref 11. Schweigel JF, Shim SS: A comparison of the treatment of gas gangrene with and without hyperbaric oxygen . Surg Gynecol Obstet 136:969-970, 1973. 12. Parker MT: Postoperative clostridial infections in Britain . Br Med J 3:671-676, 1969.Crossref 13. Duff JH, McLean PH, McLean LD: Treatment of severe anaerobic infections . Arch Surg 101:314-317, 1970.Crossref 14. Trippel OH, Ruggie AN, Staley CJ, et al: Hyperbaric oxygenation in the management of gas gangrene . Surg Clin North Am 47:17-27, 1967. 15. Lulu DJ, Rivera FJ: Gas gangrene . Am Surg 36:528-532, 1970. 16. Roding D, Groeneveld PHA, Boerema I: Ten years of experience in the treatment of gas gangrene with hyperbaric oxygen . Surg Gynecol Obstet 134:579-585, 1972. 17. Davis JC, Dunn JM, Hagood CO, et al: Hyperbaric medicine in the US Air Force . JAMA 224:205-209, 1973.Crossref 18. Brummelkamp WH: Considerations on hyperbaric oxygen therapy at three atmospheres absolute for clostridial infections type welchii . Ann NY Acad Sci 117:688-699, 1965.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jul 1, 1976

References