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Gangrene

Nurses   (2,293 Views 8 Comments)
by momrn50 momrn50 (Member) Member

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Can anyone out there tell me anything about gas gangrene?? One of our residents got a wound culture back with the organism in it that causes gas gangrene...staff is scared stiff about it and I'm having trouble finding anything out about it....HELP!!:imbar

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269 Posts; 6,119 Profile Views

I have limitation on microbiology but Gas gangrene is a kind of bacteria that grows without oxygen.

Will check more.

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269 Posts; 6,119 Profile Views

Gas Gangrene infection occurs on the postoperative patients and is an example of a sporadic infection. This kind of infection is generally considered by hospital staff to be within expected and accepted limits. ITcan occurs either in a aparticualr site or different sites that are due to the same organism and at the constant rate..

Some says it's due to a contaminated operation and this could represent the endemic level of post operative wound infections.

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teeituptom is a BSN, RN and specializes in ER, ICU, L&D, OR.

4,283 Posts; 14,100 Profile Views

Howdy Yall

From deep in the heart of texas

gas Gangrene happens, just check with your infection control nurse on how to deal with proper precautions. And why is your staff all scared of it, sounds like there is a strong need for inservicing. The only thing you have to fear, is fear itself. Do yall get this way with AIDS, Hepatitis, Meningococcal meningitis, etc. Good aseptic technique, gloves , gowns, masks, will handle anything, might be a little uncomfortable, but what the hay.

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1,244 Posts; 8,840 Profile Views

since diseases fascinate me, and I have nothing better to do, this is excerpted in part from Springhouse's 7th Ed. of PROFESSIONAL GUIDE TO DISEASES, an excellent reference book.

p. 187, 188, 189: GAS GANGRENE

"...results from ...gram-positive rod Clostridium perfingens (or another clostridial species)....with prompt treatment, 80% of patients with gas gangrene of the extremities survive. The prognosis is poorer for gas gangrene in other sites, such as the abdominal wall or the bowel. The usual incubation period is 1-4 days...."

 

"The hallmark of gas gangrene is crepitation (a crackling sensation when the skin is touched), a result of CO2 and H accumulation as a metabolic byproduct...severe localized pain, swelling, and discoloration (often dusky brown or reddish), with formation of bullae and necrosis within 36 hours from onset...."

[ gosh, this is not a pretty picture.... Anyhow...to continue]

"Treatment includes careful observation for signs of myositis and cellulitis and immediate treatment if these signs appear, immediate wide surgical excision of all affected tissues and necrotic muscle in myositis delayed or inadequate surgical excision is a fatal mistake, and, after adequate debridement, hyperbaric oxygenation, if available."

"Careful observation may result in early diagnosis. Look for s/s of ischemia (cool skin; pallor or cyanosis; sudden, severe pain; sudden edema; and loss of pulses in involved limb)."

Among other interventions, the book recommends:

"...provide adequate fluid replacement, and assess pulmonary and cardiac functions often. Maintain airway and ventillation.

 

"...provide meticulous wound care..."

 

"Psychological support is critical..."

 

"Deodorize room to control foul odor from wound..."

 

"Institute wound precautions. Dispose of drainage material properly (double-bag dressings in plastic bags for incineration), and wear sterile gloves when changing dressings. Spore-forming bacteria are not destroyed by ordinary disinfecting methods. Therefore, all contaminated equipment and linens must be autoclaved."

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live4today is a RN and specializes in Community Health Nurse.

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Alrighty then...sounds pretty MICROBIOLOGICAL to me...and yucky as well! :eek: :chuckle

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CANRN has 17 years experience as a MSN, RN and specializes in Hospice and Palliative Care, Family NP.

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Just contact isolation is neccessary when changing the dressings. It is spread by DIRECT CONTACT with the P. Clostridium bacteria.

GOOD HANDWASHING, GOWN, GLOVE, MASK and goggles if your irrigating the wound.

I just did a project on gas gangrene for my Micro class (working on my BSN) this is weird! LOL

Let me know how the person does, this is interesting since most all the 'older' nurses I work with have only seen gas gangrene once in 20+ years. Our ET nurse hand nothing on the subject!

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859 Posts; 8,844 Profile Views

Hyperbaric oxygen therapy is incredibly effective in treating gas gangrene. If you live in an area where this is available, I strongly recommend that you encourage a consultation with the nearest Hyperbaric Dept. medical director.

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