Gas gangrene. An 11-year review of 73 cases managed with hyperbaric oxygen

Abstract

An 11-year review is presented of 73 patients treated for gas gangrene at The Prince Henry Hospital. The geographical collection area extended throughout the States of New South Wales and Queensland and to Papua New Guinea. The commonest aetiological factor was found to be motor-vehicle trauma, motor-cycle accidents producing compound limb fractures in particular. The infecting organisms in these cases were most commonly clostridia. The diagnosis of the disease remains a clinical one. Treatment consisted of three facets: conservative surgery, as much of the limb or viable tissue as possible being preserved; high-dose penicillin administration; and hyperbaric oxygen therapy. Death occurred in 15 cases, gas gangrene being the principal cause in seven. However the incidence of gas gangrene has diminished since 1971, and there are hopes that it will decrease further through adequate prophylaxis and prevention in civilian surgical practice.