Myonecrotic gas gangrene of the extremities

Twenty-three patients with proven myonecrotic gas gangrene of the extremities caused by Clostridium perfringens bacteria were treated by a combination of surgical measures, benzyl-penicillin and hyperbaric oxygen at three atmospheres. 87 per cent (20/23) of the cases were cured and half of the surviving patients (10) had to be amputated at least one level higher than on admission. No single factor could be established that influenced the course of the infection comparing age under and over 50 years, vascular insufficiency and normal vascular conditions, and toxicity and non-toxicity. Nor did the level of the infection of the limb seem to have any influence. The frequency of death in relation to the described variables could not be established when multi-variance analysis was used.