Random facts 3

Question 1

Management of peripheral ischaemia

Answer 1

Aim: to save the limb

• area is kept dry
• pressure sores prevention
• monitoring of zone of demarcation
• blood supply needs to be restored if arterial disease (otherwise amputation)
• life-saving amputation required if systemic gangrene is spreading rapidly

Question 2

Gut ischaemia management

Answer 2

• rapid resuscitation
• bowel resection

Question 3

Treatment of soft tissue infections such as e.g. boils, carbuncles and abscesses

Answer 3

surgical drainage and antibiotic therapy

Question 4

Management of soft tissue anaerobic infections and gas gangrene

Answer 4

• emergency surgical debridement (and repeated debridement) of all infected dead tissue
• high dose of IV: metronidazole, penicillin and amikacin (aminoglycoside ABx)
• hyperbaric oxygen

Question 5

Tetanus infection

• Cause
• pathology
• Management

Answer 5

Tetanus

Cause: clostridium tetani

Pathology: produces endotoxin tetanospasmin -> cholinesterase at motor end plate is inhibited -> hyperexcitation of anterior horn cells -> spasms

Management: positive ventilation, muscle paralysis and anti-toxin