Details

Autor(en) / Beteiligte

• Hu, Ning
• Wu, Xing-huo
• Liu, Rong
• Yang, Shu-hua
• Huang, Wei
• Jiang, Dian-ming
• Wu, Qiang
• Xia, Tian
• Shao, Zeng-wu
• Ye, Zhe-wei

Titel

Novel Application of Vacuum Sealing Drainage with Continuous Irrigation of Potassium Permanganate for Managing Infective Wounds of Gas Gangrene

Ist Teil von

• Journal of Huazhong University of Science and Technology. Medical sciences, 2015-08, Vol.35 (4), p.563-568

Ort / Verlag

Wuhan: Huazhong University of Science and Technology

Erscheinungsjahr

2015

Quelle

MEDLINE

Beschreibungen/Notizen

• Summary： Traumatic gas gangrene is a fatal infection mainly caused by Clostridium perfringens. It is a challenge to manage gas gangrene in open wounds and control infection after debridement or amputa- tion. The aim of the present study was to use vacuum sealing drainage （VSD） with continuous irrigation of potassium permanganate to manage infective wounds of gas gangrene and observe its clinical effi- cacy. A total of 48 patients with open traumatic gas gangrene infection were included in this study. Am- putations were done for 27 patients, and limb salvage procedures were performed for the others. After amputation or aggressive debridement, the VSD system, including polyvinyl alcohol （PVA） foam dress- ing and polyurethane （PU） film, with continuous irrigation of 1：5000 potassium permanganate solutions, was applied to the wounds. During the follow-up, all the patients healed without recurrence within 8-18 months. There were four complications. Cardiac arrest during amputation surgery occurred in one pa- tient who suffered from severe septic shock. Emergent resuscitation was performed and the patient re- turned to stable condition. One patient suffered from mixed infection of Staphylococcal aureus, and a second-stage debridement was performed. One patient suffered from severe pain of the limb after the debridement. Exploratory operation was done and the possible reason was trauma of a local peripheral nerve. Three cases of crush syndrome had dialysis treatment for concomitant renal failure. In conclusion, VSD can convert open wound to closed wound, and evacuate necrotic tissues. Furthermore, potassium permanganate solutions help eliminate anaerobic microenviroument and achieve good therapeutic effect on gas gangrene and mixed infection. VSD with continuous irrigation of potassium permanganate is a novel, simple and feasible alternative for severe traumatic open wounds with gas gangrene infection.