Discussion
Which of the following is NOT appropriate in the management of gas gangrene following a contaminated road traffic accident?
Answer: A
Correct answer: Immediate suturing
Closing a contaminated wound immediately is precisely what must not be done: it seals in devitalised tissue and creates the anaerobic environment in which clostridia flourish. Such wounds are debrided, cleaned and left open, with delayed primary closure later. The other three are all part of management - radical surgical debridement of the dead muscle above all, penicillin in high dose, and, in some protocols, antitoxin, though its value is now regarded as doubtful.
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