Abstract:Objective To evaluate the role of smear examination of wound secretion in diagnosis and treatment of gaseous gangrene in open earthquake injury.
Methods Smear bacteriological examination of patients’ wound secretion were performed, patients who were suspected gaseous gangrene were isolated, operation and antiinfection treatment were offered according to patients’ condition. Further smear were performed after the wound were treated, and patients with positive smear results received operation on wound. Results 468 wound smear bacteriological examination were performed in 376 patients, 25 patients were diagnosed as gaseous gangrene combined with clinical manifestations, 20 of 25 showed enlargement of grampositive bacilli at initial smear, 12 of whom were confirmed by bacterial culture as gaseous gangrene(including 5 cases of negative smear); another 12 patients remained positive by smear examination of exudation after treatment ，and no grampositive bacilli was found after redébridement. The wounds of 25 patients infected by gaseous gangrene have been healed by the end of July,2008. During the period of earthquake remedy, all gaseous gangrene were diagnosed in emergency department, no missed diagnosis, and no nosocomial infection.
Conclusion Smear examination of wound secretion is helpful in the diagnosis of gaseous gangrene promptly, conveniently and accurately, which can improve the effects of treatment, and reduce nosocomial infection rate.