hydrophila different type of wounds variable

(12-96 h) Hour to days gas in soft tissue ICU stay critical care therapy surgery antibiotics HBO The clinical findings important for selleck chemicals llc establishing the early NF diagnosis can be divided into two groups, early and advanced symptoms [25]. Primary or idiopathic NF usually occurs in the absence of a known causative factor or entry site for bacteria spreading. On the other side, secondary NF is the result of a known etiology and takes place through laceration of skin, cut, abrasion, contusion, burns, bite, subcutaneous injection or operative incision. The most common early signs are erythema, local warmth, skin induration and edema. In the disease’s fulminant form, the patient is critically ill with signs and symptoms of severe septic shock and MODS, and extensive spreading of soft tissue necrosis. The clinical picture worsens very quickly, practically during only a few hours [25, 26]. The acute form of the infection spreads for a few days and it first begins with severe pain before the cutaneous manifestations appear.

The subacute NF form has an indolent clinical course, which progresses slowly over days or weeks [25]. Early clinical status during the first 24 hours usually includes minor trauma, skin infection like folliculitis or abscess, gangrene on the extremities, pressure sore(s), or a complicated surgical incision like hernia repair. The external signs on the skin may be erythema or induration. The patient usually feels pain on the site of the injury. There is a disproportion between the next character of the injury and intensity of the pain. Pain Mizoribine out of proportion with the apparent lesion severity should suggest a possible NF diagnosis [1, 2]. During the next 2-4 days, the pain becomes more intense. In the clinical status we find many symptoms of general toxicity like fever, dehydration, confusion, dizziness, diarrhea, nausea, vomiting, weakness and malaise. If the patient is not admitted to an ICU or the diagnosis is established late in its course, more serious clinical symptoms ensue. The limbs and

the area of body where the patient felt pain begin to swell, and may show a purplish rash or blisters with “”dish-wash”" purulent or haemorrhagic fluid. Cutaneous changes may be minimal, or may progress to blisters and bullae, and then to circumscribed 4SC-202 cell line necrosis of skin. Also, emphysema and gas formations with crepitations in overlying skin may appear. The pain grows, but remains an disproportionate to the clinical picture [1, 5, 6]. In the late phase within 4-6 days, symptoms of septic shock or MODS usually appear. Those symptoms may include cardiac shock with tachycardia, hypotension and decreased cardiac minute output, an elevated white blood cell count, metabolic acidosis, coagulopathy, changes in mental status and weakness. The patient in the late stage of NF appears apathetic and indifferent.