Gas Gangrene -Clostridial Myonecrosis
Gas gangrene is a life-threatening infection of muscle tissue caused mainly by the anaerobic bacteria Clostridium perfringens and several other species of clostridia.
The causative agent is the gas-forming anaerobic bacteria Clostridium perfringens which grows in tissues that have low oxygen tension caused by trauma or ischemia. Some conditions with low-oxygen tension are as follows:
– Minor injuries in the immunocompromised patients (HIV/AIDS, diabetes mellitus)
– Any kind of surgery (traumatic or surgical interruption of blood supply)
– Deep contamination of wound due to foreign body, soft tissue trauma and bone fracture
C. perfringens releases alpha-exotoxin that produces lethal gas, which is rapidly spreading to the muscle causing massive tissue swelling and necrosis.
Clinical symptoms of gas gangrene are :
– crepitus is felt in the soft tissue
– swollen painful wound with gas bubble in the drainage
– systemic toxemia and failure of organ systems in the body (renal damage/cardiotoxicity).
Hyperbaric oxygen therapy is a safe and effective adjunctive treatment since it works synergistically with antibiotics. Hyperbaric oxygen has bacteriostatic and bactericidal properties help kill and eliminate the bacteria. Saturation of the tissues with oxygen counteracts the life cyle of C. perfringens as it does not thrive well in an oxygen-rich environment. This decreases incidences of surgeries and amputations. Hyperbaric oxygen is a tissue-, limb- and life-saving treatment of myonecrosis.
Results of Hyperbaric oxygen therapy in Gas Gangrene
– Reduces infection by inhibition of alpha-toxin (bacteriostatic effect-formation of oxygen free radicals that prevent further alpha-toxin production)
– Enhances the effect of some antibiotics by helping in better penetration
– Provides faster and clear demarcation between dead and healthy tissue
– Promotes wound healing by restoration in blood supply
– Reduces edema by vasoconstriction
– Improves osteoclastic activity (removing necrotic bone)