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Gas Gangrene and Mixed-Clostridial Infections of Muscle Complicating Deep Thermal Burns

WILLIAM W. MONAFO, MD; LORENO BRENTANO, MD; DANIEL L. GRAVENS; RICHARD KEMPSON, MD; CARL A. MOYER, MD
Arch Surg. 1966;92(2):212-221. doi:10.1001/archsurg.1966.01320200052010.
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DURING two years, intensive bacteriologic study of the wounds of 50 patients suffering from major thermal burns has been performed at the Hartford Burn Unit in the Barnes Hospital. Anaerobic techniques were not used routinely, but only if the clinical circumstances seemed to warrant it. Despite this somewhat casual approach, clostridia were recovered in 45 of 1,843 consecutive cultures from 11 (22%) of the patients. In four patients the organisms were considered to be mere contaminants and of no apparent clinical significance. In seven patients with deep burns that extended to muscle, a mixed infection of muscle occurred from which pathogenic clostridia of several species, as well as a variety of other organisms, were recovered. The infection invariably resulted in severe systemic illness and either in extensive tissue loss or in amputation. All seven patients died: one patient of gas gangrene, another of septicemia due to Escherichia coli, Pseudomonas aeruginosa

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