Comprehensive treatment for gas gangrene of the limbs in earthquakes / 中华医学杂志(英文版)
Chinese Medical Journal
; (24): 3833-3839, 2013.
Article
em En
| WPRIM
| ID: wpr-236154
Biblioteca responsável:
WPRO
ABSTRACT
<p><b>BACKGROUND</b>Mortality rates for patients with gas gangrene from trauma or surgery are as high as 25%, but they increase to 50%-80% for patients injured in natural hazards. Early diagnosis and treatment are essential for these patients.</p><p><b>METHODS</b>We retrospectively analyzed the clinical characteristics and therapeutic results of 19 patients with gas gangrene of the limbs, who were injured in the May 2008 earthquake in the Wenchuan district of China's Sichuan province and treated in our hospital, to seek how to best diagnose and treat earthquake-induced gas gangrene.</p><p><b>RESULTS</b>Of 226 patients with limbs open injuries sustained during the earthquake, 53 patients underwent smear analysis of wound exudates and gas gangrene was diagnosed in 19 patients. The average elapsed time from injury to arrival at the hospital was 72 hours, from injury to definitive diagnosis was 4.3 days, and from diagnosis to conversion of negative findings on wound smear analysis to positive findings was 12.7 days. Anaerobic cultures were also obtained before wound closure. The average elapsed time from completion of surgery to recovery of normal vital signs was 6.3 days. Of the 19 patients, 16 were treated with open amputation, two with closed amputation, and 1 with successful limb salvage; 18 patients were successfully treated and one died.</p><p><b>CONCLUSIONS</b>In earthquakes, rapid, accurate screening and isolation are essential to successful treatment of gas gangrene and helpful in preventing nosocomial diffusion. Early and thorough debridement, open amputation, and active supportive treatment can produce satisfactory therapeutic results.</p>
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Índice:
WPRIM
Assunto principal:
Patologia
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Cirurgia Geral
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Estudos Retrospectivos
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Diagnóstico
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Extremidades
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Terremotos
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Gangrena Gasosa
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Screening_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Child
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Female
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Humans
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Male
Idioma:
En
Revista:
Chinese Medical Journal
Ano de publicação:
2013
Tipo de documento:
Article