Treatment for clostridial myonecrosis (gas gangrene) includes which of the following measures?
1.Administration of an antifungal agent
2.Administration of antitoxin
4.Administration of hyperbaric oxygen
a. Necrotizing skin and soft tissue infections may produce insoluble gases (hydrogen, nitrogen,methane) through anaerobic bacterial metabolism.
b. While the term “gas gangrene” has come to imply clostridial infection, gas in tissues is more likely not to be due to Clostridium species but rather to other facultative and obligate anaerobes, particularly streptococci.
c. Though fungi have also been implicated, they are less often associated with rapidly progressive infections. Treatment for necrotizing soft tissue infections includes repeated wide debridement, with wound reconstruction delayed until a stable, viable wound surface has been established.
d. The use of hyperbaric oxygen in the treatment of gas gangrene remains controversial, due to lack of proven benefit, difficulty in transporting critically ill patients to hyperbaric facilities, and the risk of complications.
e. Antitoxin has neither a prophylactic nor a therapeutic role in the treatment of myonecrosis.