How to Treat Gas Gangrene

Gas gangrene is an infection usually caused by the Clostridium perfingens bacteria, but it can also be caused by Group A Streptococcus. These bacteria grow in low oxygen conditions and produce toxins that kill tissue and produce other symptoms. Most patients who develop gas gangrene have a blood vessel disease, diabetes or colon cancer; a third of the cases develop spontaneously.

Instructions

Difficulty: Challenging

1. Provide oxygen and intravenous fluids to correct electrolyte abnormalities when treating gas gangrene outside a hospital setting.
2. Manage the patient's airway and breathing and assess the circulatory status frequently. Vasoconstrictors should be used only if necessary, as this can further reduce the circulation to ischemic tissue. Provide a tetanus vaccine if needed.
3. Administer general penicillin-type antibiotics intravenously at first before a diagnosis has been made. Once a diagnosis of gas gangrene has been made, clindamycin and penicillin G should be given orally, as clostridium is sensitive to this combination. Vancomycin or linezolid may be used for patients at risk for methicillin resistant Staphyulococcus aureus (MRSA.) Some patients with MRSA are now being isolated even if they are not high risk.
4. Use analgesics to control the pain. Hyperbaric oxygen therapy has been tried with some success.
5. Remove damaged, dead and infected tissue with surgery as quickly as possible. It may be necessary to amputate a limb to control the spread of gas gangrene.