Erttmann M, Hobrecht R, Havemann D
Chirurgische Universitätsklinik, Abteilung Unfallchirurgie, Kiel.
Zentralbl Chir. 1992;117(9):509-14.
Between 1978 and 1990 98 patients with gas gangrene were treated in the departments of general surgery and traumatology of the University of Kiel. The microbiological results of tissue samples and results of animal infectious experiments were correlated to the clinical outcome. It could be shown, that gas gangrene due to C.perfringens alone had a higher mortality than gas gangrene due to polymicrobial infection. In trauma patients, however, the rate of amputations was lower in cases of clostridial monoinfections (25%), than in patients with mixed infections (48%). The results of animal experiments with guinea pigs which were infected by patients' infectious material showed a correlation to the clinical outcome. This correlation could not bee shown using isolated and cultured clostridia. Therefore and because of the quantity of mixed infections it is necessary to use broad spectrum antibiotics for treatment in cases of gas gangrene and for perioperative antibiotic prophylaxis. Penicillin-G alone can not more be recommended for this purpose.
1978年至1990年间，基尔大学普通外科和创伤科收治了98例气性坏疽患者。组织样本的微生物学结果及动物感染实验结果与临床结局相关。结果表明，仅由产气荚膜梭菌引起的气性坏疽比多微生物感染引起的气性坏疽死亡率更高。然而，在创伤患者中，梭菌单一感染病例的截肢率（25%）低于混合感染患者（48%）。用患者感染材料感染豚鼠的动物实验结果与临床结局相关。使用分离培养的梭菌则未显示出这种相关性。因此，鉴于混合感染的数量，气性坏疽病例的治疗及围手术期抗生素预防有必要使用广谱抗生素。仅青霉素G已不再推荐用于此目的。
