b. Staphylococcal Infections.
(1) Signs/symptoms. The basic symptoms of swelling, pain, redness, and
heat at the infection site are present. There may be abscess formation at the site also.
Initially the abscess will be firm, then it becomes yielding when touched indicating that
the center is full of liquid (pus). The abscess will often drain spontaneously, and thick
yellow or cream colored pus will come out. Lymphadenitis, inflammation of the lymph
glands, and lymphangitis, inflammation of the lymphatic vessels, are both common
manifestations of staphylococcal infections.
(2) Treatment. Have the patient rest and elevate the affected area. Then,
apply moist, warm compresses to promote the healing process. In a relatively small,
recent wound, this treatment will usually be sufficient. If the wound is large and
purulent, complete these first two steps, and then make an incision and drain the
wound. Squeeze out any exudate in the wound. Irrigate the wound with normal saline
solution and/or antiseptic solution such as povidone-iodine. Clean the wound
thoroughly being sure all foreign matter and exudate has been removed. Dress the
wound with sterile gauze packing. Use iodoform gauze to stuff down in the wound with
just the tip, the wick, sticking up. This gauze will soak up the exudate which will be
made as part of the healing process. The wick is to allow the person changing the
dressing to removed the soiled gauze easily. Put a nonadherent cover over the wicking.
(Telfa is a plastic-like coating on one side of a gauze dressing that prevents the
dressing from adhering to the wound.) Be sure the dressing is changed daily.
c. Streptococcal Infections.
(1) Signs/symptoms. As with staphylococcal infections, the basic symptoms
are swelling, pain, redness, and heat at the infection site. Generally, there is no
abscess formation, but there is a rapid spread of infection from the edge of the wound
outward through the skin and subcutaneous tissue.
(2) Treatment. Advise the patient to rest and elevate the affected area.
Apply moist, warm compresses to promote the healing process. Always administer
antibiotic therapy as directed by a physician.
d. Gas Gangrene (Clostridium Bifermentans or Clostridium Perfringens,
Class A and F.) Gas gangrene is an infection that comes on suddenly and violently in
dead tissue and spreads rapidly. The infection is caused by one of several clostridia--
Clostridium perfringens, Clostridium novyi, Clostridium speticum, etc. Moving into dead
or dying tissues, these organisms use amino acids and carbohydrates from the cells.
Gas is produced which stretches tissues and interferes with blood supply and
oxygenation. The organisms multiply and secrete enzymes which destroy living tissues
adjacent to the wound as well as red blood cells. In this way, infection continues to
spread. As the organisms continue to multiply, infection accelerates and advances,
making severe anemia and toxemia possible. Eventually, acute toxemia may result in
shock and rapid death.