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Образование - счетчик, рейтинг, каталог - FLEXER

Gas gangrene

gas phlegmon, malignant edema, gangrene, heavy sharp infekts. the disease, caused by a number microbe- Clostridium (Cl perfringens, Cl septicum, Cl oede-matiens, Cl histolyticum), that are developed without the access of oxygen (anaerobic infection). It appears in the deep torn, crushed extensive wounds with the pockets and the deepenings with the disturbance of local blood circulation. Especially frequently is encountered into voyen. time, it is almost exclusive on the extremities (usually on the lower). It strikes all soft tissues, but mainly fatty tissue and muscle with g. g. the classical signs of inflammation be absent. Process is characterized by progressive edema, gas formation in the cloths, general grave condition, numbness of tissue of organisms, caused by poisoning spetsifich. by the toxins of pathogens of disease, and also by decay products of cloths. Inkubats. the period of 3-5 sous t. The struck extremity rapidly increases in the volume. 2 phases are distinguished in accordance with the local changes in the flow of process: the formation of edema and development g. g. with gas generation in the perishing cloths (edema - the reaction of cloths to the action of toxins, the gas - the result of decomposition by toxins of muscular glycogen and proteins).

On the spot g. g. appear the strong bursting open pain in the wound, edema; the skin at first pale, then is covered with brown, bronze or dark-blue spots, by feel - cold. With the emphysematous classical form the gas formation predominates above edema. Wound dry, with the pressure from it are separated gas bubbles; muscles at first take the form of boiled meat, then they become dark with the greenish nuance; cellulose is colored dull gray. With the edematic (toksich.) to the form of cloth they take the form of jelly; blood-containing- serous liquid is separated from the wound; it is small gas in the cloths.

They are encountered mixed and other untypical forms g. g. with these forms the general state of patient rapidly deteriorates, increase the phenomena of intoxication by the products of the vital activity of microbes and disintegration of the killed cloths. Rate -.pa rises to 39-40 °S, pulse is make mored frequent (130-150 impacts in min), arterial pressure is reduced (80 mm Hg. and is below), respiration make mored frequent. In patient begin the general excitation or oppression, insomnia; consciousness is usually preserved. Treatment: special operation, serotherapy, antibiotics, the blood transfusion. Preventive maintenance: the early treatment of wound, anti-gangrenous serum. P. B. Avisov.