Abstract
Gas-producing infections, such as clostridial and nonclostridial gas gangrene, crepitant
cellulitis, and necrotizing fasciitis, are characterized in the literature by a variety
of initial presentations, microbial burdens and surgical outcomes—ranging from debridement
to amputation to death. The primary aim of this study was to identify the organisms
cultured in gas-producing infections of the foot in patients that presented to a large
academic medical center over a 10-year period. Our secondary aims were to report the
prevalence of sepsis in this population upon presentation, and patient outcomes upon
discharge. After a retrospective chart review of 207,534 procedures, 70 surgical cases
met inclusion criteria. The most common organisms that grew in operating room cultures
were Staphylococcus aureus, Group B Beta Streptococcus, and Enterococcus species. Just over half of the population presented with sepsis. After an average
of 2 or more operations, 64% of patients underwent amputation. One death occurred.
Gas-producing infections, or “gas gangrene,” are primarily polymicrobial infections,
rarely due to Clostridium perfringens, that warrant surgical exploration for optimal outcomes.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: September 25, 2022
Footnotes
Financial Disclosures: None reported.
Conflict of Interest: None reported.
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© 2022 by the American College of Foot and Ankle Surgeons. All rights reserved.
