Prevention of a mephitic gangrene

Description:

Prevention of a mephitic gangrene is first of all observance of rules of an asepsis, full-fledged surgical treatment of wounds, timely fight against traumatic and hemorrhagic shock, a rational immobilization.

It is officially recommended at extensive destructions of the muscles, wounds which are strongly contaminated by the earth, clothes scraps and also in cases when the styptic plait was imposed, with the preventive purpose to enter 30 000 ME serums (on 10 000 ME аптиперфрингенс, антиэдематиенс, антнеептикум) intramusculary. However its effect is insignificant. Preventively bacteriostatic and bactericidal drugs are much more effective. At surgical treatment of the extensive smashed wounds of soft tissues with injury of bones, bullet wounds it is necessary to carry out all rules of surgical treatment carefully. This extensive, labor-consuming and delicate operation demands use of a deep anesthesia with muscle relaxants, good knowledge of anatomy and high qualification of the surgeon. The karkasnost of a bone skeleton and a blood stream have to be ideally recovered. It is in certain cases reasonable to operate together with traumatologists and angiokhirurga. The issue of suture on such debrided wound in peace time has to be resolved rationally, it is not necessary to ignore rare, provisional, and also otstrochenny seams. At operative measures on intestines, especially on its distal departments, it is necessary to remember a possibility of infection with clostridiums from intestines of soft tissues of an operational wound. Therefore at the most strict observance of rules of an asepsis it is necessary to choose rationally anesthesia, type and size of a section, to make thrifty use of fabrics, not to put unfairly frequent stitches.