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Case 5: Significant abdominal wound infection

7 days after a laparotomy this lady was very unwell with infection spreading from her abdominal wound. Blood gases were taken.

1. What do they demonstrate?.

Extreme metabolic acidosis.
Maximum respiratory compensation.
Significant base excess.
Adequate oxygenation if breathing room air.

2. What do you think of her wound infection now?

In the absence of another clear cause, the wound infection is obviously causing significant systemic sepsis. In fact, the infection has probably evolved into a necrotising fasciitis process and may be lethal.

Rapid resuscitation, IV antibiotics and wide surgical debridement will probably be necessary.

There is some evidence that hyperbaric oxygen therapy has some benefit in treating these very unwell patients.

Further Reading --- emedicine --- Necrotising Fasciitis