Wednesday, September 13, 2006

Genral Surgery Mcq-Answer 1

Correct Answer is C

The most effective way to avoid gas gangrene is to remove ALL evidently necrotic tissue which is the media or the substrate for the growth of Clostridia. It should be surgically removed or devitalized tissues until there is tissue BLEEDING. Mechanical wash of the wound with saline for an adequate time is also very effective to remove all foreign bodies which are common to be found in the wound after a motor car accident.

Penicillin G is the drug of choice for the eradication of Clostridia and it should be included in any antibiotic combination, but it is NOT any mean a substitute for local mechanical debridement.

Contrary to common believe, anti gas gangrene serum has a MINOR role in the management. It is rarely needed.

Rapid suturing of the wound is WRONG, unless the wound is recent (and organisms did not colonize and multiply), not deep, and you are sure that you left no devitalized tissues or foreign body. In severe deep wound it is some times much safer to leave the wound opened after irrigation and debridment for delayed suture few days later.

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