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Novel application of vacuum sealing drainage with continuous irrigation of potassium permanganate for managing infective wounds of gas gangrene

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Summary

Traumatic gas gangrene is a fatal infection mainly caused by Clostridium perfringens. It is a challenge to manage gas gangrene in open wounds and control infection after debridement or amputation. The aim of the present study was to use vacuum sealing drainage (VSD) with continuous irrigation of potassium permanganate to manage infective wounds of gas gangrene and observe its clinical efficacy. A total of 48 patients with open traumatic gas gangrene infection were included in this study. Amputations were done for 27 patients, and limb salvage procedures were performed for the others. After amputation or aggressive debridement, the VSD system, including polyvinyl alcohol (PVA) foam dressing and polyurethane (PU) film, with continuous irrigation of 1:5000 potassium permanganate solutions, was applied to the wounds. During the follow-up, all the patients healed without recurrence within 8–18 months. There were four complications. Cardiac arrest during amputation surgery occurred in one patient who suffered from severe septic shock. Emergent resuscitation was performed and the patient returned to stable condition. One patient suffered from mixed infection of Staphylococcal aureus, and a second-stage debridement was performed. One patient suffered from severe pain of the limb after the debridement. Exploratory operation was done and the possible reason was trauma of a local peripheral nerve. Three cases of crush syndrome had dialysis treatment for concomitant renal failure. In conclusion, VSD can convert open wound to closed wound, and evacuate necrotic tissues. Furthermore, potassium permanganate solutions help eliminate anaerobic microenvironment and achieve good therapeutic effect on gas gangrene and mixed infection. VSD with continuous irrigation of potassium permanganate is a novel, simple and feasible alternative for severe traumatic open wounds with gas gangrene infection.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Institute for Orthopaedic Research and Education, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China

    Ning Hu  (胡宁) & Dian-ming Jiang  (蒋电明)

  2. Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    **ng-huo Wu  (吴星火), Shu-hua Yang  (杨述华), Wei Huang  (黄玮), Qiang Wu  (吴**), Tian **a  (夏天), Zeng-wu Shao  (邵增务) & Zhe-wei Ye  (叶哲伟)

  3. Department of Orthopaedic Surgery, Wuhan Puren Hospital, Wuhan University of Science and Technology, Wuhan, 430080, China

    Rong Liu  (刘融)

Authors
  1. Ning Hu  (胡宁)
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  2. **ng-huo Wu  (吴星火)
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  3. Rong Liu  (刘融)
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  4. Shu-hua Yang  (杨述华)
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  5. Wei Huang  (黄玮)
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  6. Dian-ming Jiang  (蒋电明)
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  7. Qiang Wu  (吴**)
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  8. Tian **a  (夏天)
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  9. Zeng-wu Shao  (邵增务)
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  10. Zhe-wei Ye  (叶哲伟)
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Corresponding author

Correspondence to Zhe-wei Ye  (叶哲伟).

Additional information

Both authors contributed equally to this work.

This study was supported by a grant from the National Natural Science Foundation of China (No. 81201393).

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Hu, N., Wu, Xh., Liu, R. et al. Novel application of vacuum sealing drainage with continuous irrigation of potassium permanganate for managing infective wounds of gas gangrene. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 35, 563–568 (2015). https://doi.org/10.1007/s11596-015-1471-9

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  • DOI: https://doi.org/10.1007/s11596-015-1471-9

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