[Characteristics of wound infection in long-term crush syndrome]. 1990

V D Fedorov, and O K Borisova, and S E Kuleshov, and M V Pavlova, and S I Pal'mina, and V A Kosaia, and I N Bakulin

Clinicobacteriological examination was carried out in 31 patients with the crush syndrome (CS) and extensive damage to the soft tissues in combination with bone fractures complicated by wound infection. Inadequate surgical treatment in the early periods after the trauma (complete closure of the wound, making small incisions of the involved skin and subcutaneous fat) is particularly hazardous in such cases because it leads to the development of severe wound infection. This disease is marked by a complex polymicrobial structure of the causative agents, massive dissemination of aerobic and opportunistic anaerobic bacteria in the purulent focus (10(7)-10(9) microbial bodies), and a high proportion (48.4%) of obligate anaerobic microflora. Wound infection in the CS takes a grave clinical course, but without profound microbiological study it is difficult to differentiate it into aerobic and anaerobic (clostridial and ++non-clostridial) forms. This is evidence of the need for emergency extended bacteriological diagnosis at all the stages of treatment. "Pure" aerobic infection was identified in half of the patients and mixed aerobic-anaerobic infection in the other half. The possibility of the involvement of asporogenic anaerobes is shown (35.5% of cases). The high risk of the development of gas gangrene is detected (9.7%) and its is concluded that early prevention is necessary by adequate surgical intervention, adequate intensive antibacterial and detoxification therapy, including hyperbaric therapy. The efficacy of current antigangrene immunization agents must be evaluated.

UI MeSH Term Description Entries
D009104 Multiple Trauma Multiple physical insults or injuries occurring simultaneously. Injuries, Multiple,Trauma, Multiple,Wounds, Multiple,Multiple Injuries,Polytrauma,Injury, Multiple,Multiple Injury,Multiple Traumas,Multiple Wound,Multiple Wounds,Polytraumas,Traumas, Multiple,Wound, Multiple
D003444 Crush Syndrome Severe systemic manifestation of trauma and ischemia involving soft tissues, principally skeletal muscle, due to prolonged severe crushing. It leads to increased permeability of the cell membrane and to the release of potassium, enzymes, and myoglobin from within cells. Ischemic renal dysfunction secondary to hypotension and diminished renal perfusion results in acute tubular necrosis and uremia. Crush Syndromes,Syndrome, Crush,Syndromes, Crush
D004190 Disasters Calamities producing great damage, loss of life, and distress. They include results of natural phenomena and man-made phenomena. Normal conditions of existence are disrupted and the level of impact exceeds the capacity of the hazard-affected community.
D005738 Gas Gangrene A severe condition resulting from bacteria invading healthy muscle from adjacent traumatized muscle or soft tissue. The infection originates in a wound contaminated with bacteria of the genus CLOSTRIDIUM. C. perfringens accounts for the majority of cases (over eighty percent), while C. noyvi, C. septicum, and C. histolyticum cause most of the other cases. Gangrene, Gas,Gangrenes, Gas,Gas Gangrenes
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001136 Armenia An ancient country in western Asia, by the twentieth century divided among the former USSR, Turkey, and Iran. It was attacked at various times from before the 7th century B.C. to 69 B.C. by Assyrians, Medes, Persians, the Greeks under Alexander, and the Romans. It changed hands frequently in wars between Neo-Persian and Roman Empires from the 3d to 7th centuries and later under Arabs, Seljuks, Byzantines, and Mongols. In the 19th century Armenian nationalism arose but suffered during Russo-Turkish hostilities. It became part of the Soviet Republic in 1921, with part remaining under Turkey. (Webster's New Geographical Dictionary, 1988) Armenian S.S.R.,Armenian SSR
D001424 Bacterial Infections Infections by bacteria, general or unspecified. Bacterial Disease,Bacterial Infection,Infection, Bacterial,Infections, Bacterial,Bacterial Diseases
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor
D014946 Wound Infection Invasion of a wound by pathogenic microorganisms. Infection, Wound,Infections, Wound,Wound Infections

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