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    Gangrena Gazoasa

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    Andrei Sandu
    Gangrena gazoasa is caused by anaerobic bacteria that produce gas and toxins, resulting in tissue necrosis. It typically develops after surgical infections, burns, or wounds. Clinically, it presents with local swelling, foul-smelling secretions, pale or discolored skin, and systemic symptoms like fever or shock. Treatment involves antibiotics, surgery to remove dead tissue, and hyperbaric oxygen therapy.

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    Gangrena Gazoasa

    Uploaded by

    Andrei Sandu
    113 views26 pages
    Gangrena gazoasa is caused by anaerobic bacteria that produce gas and toxins, resulting in tissue necrosis. It typically develops after surgical infections, burns, or wounds. Clinically, it presents with local swelling, foul-smelling secretions, pale or discolored skin, and systemic symptoms like fever or shock. Treatment involves antibiotics, surgery to remove dead tissue, and hyperbaric oxygen therapy.

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    Gangrena gazoasa

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    Gangrena gazoasa is caused by anaerobic bacteria that produce gas and toxins, resulting in tissue necrosis. It typically develops after surgical infections, burns, or wounds. Clinically, it presents with local swelling, foul-smelling secretions, pale or discolored skin, and systemic symptoms like fever or shock. Treatment involves antibiotics, surgery to remove dead tissue, and hyperbaric oxygen therapy.

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    © All Rights Reserved
    Flag for inappropriate content
    113 views26 pages

    Gangrena Gazoasa

    Uploaded by

    Andrei Sandu
    Gangrena gazoasa is caused by anaerobic bacteria that produce gas and toxins, resulting in tissue necrosis. It typically develops after surgical infections, burns, or wounds. Clinically, it presents with local swelling, foul-smelling secretions, pale or discolored skin, and systemic symptoms like fever or shock. Treatment involves antibiotics, surgery to remove dead tissue, and hyperbaric oxygen therapy.

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    GANGRENA

    GAZOASA
    GANGRENA GAZOASA

    GERMENI
    ANAEROBI

    GANGRENA TOXEMIE
    GAZE
    TESUTURILOR GRAVA
    GANGRENA GAZOASA

    Germeni telurici /Saprofiti intestinali


     Se dezvolta pe medii de cultura speciale
     Produc gaze urat mirositoare
    GANGRENA GAZOASA
    Studiu bacteriologic
     Cl. Perfringens ( -toxina) si aedematiens
     Bacteroides fragilis
     B. histolyticus, B. sporogenes, B. putrificus
     Micrococus fablax, coci anaerobi
     Asocieri bacteriene: germeni gram poz. anaerobi
    1. Toxine difuzibile
    2. Necroze musculare, nervoase, sangvine
    3. Efect leucocidinic si leucotactic
    GANGRENA GAZOASA
    Etiologie
     Infectii chirurgicale digestive
     Explorari urologice
     Infectii perianale
     Arsuri suprainfectate
     Degeraturi
     Fracturi deschise
     Avort septic
     Ulcer varicos
    GANGRENA GAZOASA
    Etiologie

    Conditii favorizante:
    1. Plagi contuze
    2. Ischemie locala

    3. Corpi straini infectati


    GANGRENA GAZOASA
    Etiologie
    Tare asociate favorizante
     Socul traumatic
     Anemia

     Diabetul

     Hipoproteinemia

     Imunodepresia

     Cancerul

     Ateroscleroza
    GANGRENA GAZOASA
    Anatomie patologica
    Macroscopic Microscopic
     Edem  Necroze ale fibrelor
     Emfizem musculare si edem
     Secretie abundenta,  Miozita supraacuta cu
    fetida, tulbure + bule de degenerescenta Zenker
    gaz  Edem  infiltrat leuc.
     Aspect de “carne fiarta”  Tromboze vasculare
    al musculaturii
    GANGRENA GAZOASA
    Semne clinice locale
     Debut: 12h3-4zile  Tegumente:
     Tumefactie = edem Luciose, palide
     Secretie brun-maronie + 
    gaze + miros fetid Reci, cianotice, marmorate
     Absenta pulsului 
    periferic local Placarde brun-maronii
     Absenta durerii (eritem bronzat Velpeau)
     Impotenta functionala 
    Flictene sangvinolente

    Escare negricioase
    GANGRENA GAZOASA
    Semne clinice generale

     Febra/hipotermie+frisoane
     Obnubilare/agitatie  coma

     Dispnee, tahicardie, puls slag

     Hipotensiune  colaps

     Deshidratare  oligurie

     Icter sclero-tegumentar, s.a.


    GANGRENA GAZOASA
    Paraclinic
     Hemoconcentratie
     Leucocitoza/leucopenie
     Anemie hemolitica
     Retentie azotata, hiperbilirubunemie
     Hemoculturi +/_
     Frotiu din secretie
     Culturi + antibiograma
    GANGRENA GAZOASA

     Forme clinice  Forme anatomopatologice


    1. Circumscrisa 1. Abcesul gazos
    2. Difuza 2. Celulita
    3. Masiva 3. Gangrena gazoasa
    4. Forma edematoasa
    (“erizipelul alb”)
    GANGRENA GAZOASA
    Tratament
     Tratament chirurgical
     Tratamentul socului septic
     Oxigenoterapie hiperbara
     Antibioterapie
     Seroterapie antigangrenoasa
    1. Ser polivalent: 50.000-200.000UI iv/im/pl
    2. Ser monovalent: 30.000UI iv
    GANGRENA GAZOASA

    Etape evolutive
    1. Debut local si sistemic
    2. Catabolica
    (delimitarea sfacelelor  pierderi proteice)
    3. Cicatrizare si tratament al sechelelor

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