Infections with traumas
Traumatology / / August 12, 2017
anaerobic wound infection
anaerobic wound infection is among the most severe complications of acute period of trauma.The likelihood of this complication increases with the open comminuted fractures to crush the soft tissues, especially in acute disorders of local blood circulation, the presence of necrotic tissue and foreign bodies.
main signs anaerobic infections
early characteristic feature of anaerobic infections are strong, arching pain in the injured limb segment.Pains arise, as a rule, against a background of relative prosperity, a few hours after surgical treatment (or toilet) wounds, reduction and fixation of bone fragments.Pains are stubborn, they can not be removed drugs, do not disappear after dissecting the cast and the weakening of all other types of dressings.Pain violate peace and patient sleep.Later they were joined by progressively increasing swelling of tissue (from the periphery to the center), purple-bluish color or abrupt paleness of skin, tissue crepitus (accumulation of gas
Treatment of anaerobic infections
Treatment should be energetic and immediate.For suspected anaerobic infection of the victim is taken in the dressing room or the operating room, remove the plaster cast, wound dissolving stitches, examine tissue in wound depth (especially muscle).With obvious signs of gas gangrene produces a wide dissection of the soft tissue to the bone with the opening of all the fascial sheaths ( "lampasnye" sections).
If the pathological process progresses, amputation produce 15-20 cm proximal to the visual boundaries of the affected tissues.The operation was performed under general anesthesia, a tourniquet on the limb does not impose, postoperative wound is left open.Simultaneously
carried powerful antibiotics (penicillin intravenously to 20-30 million units daily.) Serotherapy - intravenously administering polyvalent serum (in isotonic sodium chloride solution 1: 4) to 150 000 ME per day at 1 ml / minhyperbaric oxygenation.
- abdominal organ injuries (general information)
- spinal injuries in conjunction with liver damage and spleen
- First aid and treatment for injuries of the abdomen
- struggle with pain in injuries
- Multiple fracturesfemur
- multiple fractures of the tibia
- multiple fractures ankle
- struggle with acute blood loss in trauma
- Technique overlay
- harness clinical picture pelvis multiple fractures
- Combined treatment of injuries
- multiple fractures treatment ribs
putrid infection refers to the dangerous complications of open polifraktur.
main signs of putrid infection
Meltdown soft tissue in the wound with copious hemorrhagic exudate with smelly gas, high temperature general reaction, often - the clinical picture of sepsis.
Radical excision of nonviable tissue, opening of "pockets", broad streaks of drainage, excessive prolonged washing wounds with an antiseptic solution.It is shown that a powerful antibacterial and transfusion therapy.
When an unknown exciter shown:
1. cephalothin - 6-10 r / d.IV plus gentamicin 0,16-0,24 g / day intravenously, intramuscularly.
2. Oxacillin - 2-4 g / day intravenous ampicillin + 4-10 g / day intravenously or carbenicillin 30 g / day intravenous plus gentamicin 0,16-0,24 g / day intravenously, intramuscularly.
3. Penicillin 20 million units / day IV + oxacillin 2-4 g / day intravenous plus gentamicin 0,16-0,24 g / day intravenously, intramuscularly.