[Gas gangrene].

In spite of surgical, intensive, and hyperbaric oxygen therapy, the gas gangrene is still one of the most dangerous surgical infections. In recent literature, the average mortality is about 50%. The patients die within a few days because of general intoxication. A review of our own results achieved between 1971 and 1981 shows that 50 out of 73 patients with clostridium infection and all 77 patients in whom a gas gangrene was suspected have survived [ 2 ]. For the prognosis and therapy of the gas gangrene, the classification into stages I to IV according to the severity has proved to be useful. The prognosis depends on the incubation period (the shorter the incubation period the worse the prognosis), on the beginning of the treatment and on the site of a primary or secondary gas gangrene. The more distally the gas gangrene is situated in the extremities, the better is the prognosis with regard to mortality and invalidity. An early diagnosis of the gas gangrene is of primary importance. As early as a gas gangrene is suspected because of typical local findings and clinical symptoms, therapeutic measures are immediately necessary (surgery, intensive treatment and hyperbaric oxygen therapy). A transport of more than six hours with prolonged interruption of the treatment will decrease the chances of success even in a "gas gangrene therapy centre".