Causes and risk factors
Gas gangrene is caused by Clostridium perfringens bacteria. Other bacteria causing gas gangrene include Staphylococcus aureus, group A Streptococcus, or Vibrio vulnificus. It affects deep muscle tissues. It develops in an injury or surgical wound that is deprived of blood supply. There is formation of gas bubbles and toxins inside the affected area thus called as gas gangrene. The diseases and conditions that are associated with a higher risk of developing gas gangrene are arteriosclerosis, Raynaud’s disease, diabetes, hernia, appendicitis, presence of blood clots, reduced immunity due to certain diseases or treatments, history of recent surgery, history of recent trauma [especially where body tissues are crushed], frostbite, burns, animal bites, etc., indulging in alcohol, smoking, intravenous drug use, etc.
Clinical presentation
Progressive inflammation leads to death of deep muscle tissue manifesting skin symptoms. The symptoms of gas gangrene develop rapidly and spread quickly. There is presence of toxic gas formation under the skin due to release of toxins and death of muscle tissue. Skin shows blisters filled with brown-red fluid. Foul-smelling, brown-red or bloody fluid drains from the tissues. Patient experiences pain around a skin injury. Skin colour is pale, which later becomes dark red or purple. There is increasing swelling around a site of injury. Associated signs and symptoms include tachycardia [increased heart rate], fever, sweating, yellow discoloration of the skin [jaundice].
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Microscopic examination of affected tissue or fluid from blisters to check for bacteria is done. Complete blood count is recommended. Imaging studies such as x-rays, MRI scans, or CT scans to check the spread of gangrene in the internal tissues are advised. Arteriogram may be done to detect whether there is blockage in the arteries.
Treatment
Medical treatment involves antibiotics. Hyperbaric oxygen chamber is useful to provide an oxygen rich environment for slow progression of gas gangrene. Surgery involves one or more of the following – debridement of the dead tissue; reconstruction of the affected area with the help of skin grafts; amputation of the affected limb or body part; vascular surgery to improve blood supply. Prevention of gangrene is possible by good diabetic care. Prompt treatment of any wound, precautionary measures against development of frostbite. Avoidance of use of tobacco, alcohol, intravenous substance abuse, etc., will contribute further to the treatment.
Other Modes of Treatment
The other modes of treatment can also be effective in treating gas gangrene. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates is also found to be effective in treating gas gangrene.
