High dose penicillin G along with broad spectrum
anti-biotic i.e third generation cephalosporins and metronidazole should be
given intra-venously untill the patient,s toxicity abates . The cornerstone of
management is surgical excision of the
necrotic tissue . The fascial planes are opened with ease as the
infection produces inflatory degloving and the yellowish green necrotic fascia
is vissible . Devitalised tissue should be removed generously The wound is
lightly packed with fluffed gauze and dressed . In patients who survive , this
results in a larged wound which will require skin grafting or flap coverage .
Recently the role of hyperboric oxygen has become more established . The
patient is placed in a high pressure chamber and 100% oxygen administered at a
pressure of 2-3 atmosphere
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