Gangrenous infection by soil-borne bacteria was common in the combat injuries of soldiers well into the 20th century, because of non-sterile field surgery and the basic nature of care for severe projectile wounds.

It can easily be noticed by the large, blackened sores that form, as well as a degree of loud and distinctive crepitus caused by gas escaping the necrotic tissue.

Symptoms include:[4] Clostridium species produce more toxins and exhibit higher degrees of virulence than any other bacterial taxon.

C. perfringens alpha toxin is widely associated with gas gangrene as it is its main virulence factor whilst invading its host.

Alpha-toxin causes excessive platelet aggregation which blocks blood vessels and deprives the vital organs of oxygen supply.

As the surrounding circulatory system collapses, neutrophils and monocytes, eosinophils and basophils cannot reach target areas of infection.

[6] This inflammatory response leads to constriction of surrounding arteries and promotes an anaerobic environment for C. perfringens growth and pathophysiology.

Superficial necrosis is unsightly and can lead to unattractive scarring, but otherwise does not affect the patient's likelihood of survival or physical capability to the same extent.

[citation needed] It is often difficult to identify the extent of muscle damage, as C. perfringens may be at work in deeper fascial layers below the skin.

This is due to the lysis of neutrophils, a type of white blood cell, caused by the lecithinases and other toxins released by Clostridium species.

When such bacteria are able to enter a living host, they encounter a vast supply of nutrients, warm conditions, and an abundance of water.

Alongside such rapid proliferation is a corresponding mass-production of exotoxin that causes severe damage to local tissue in the host.

Massive infection is likely to result in death from a combination of system-wide septic shock and the unintentionally damaging effects of the immune response.

When gas gangrene occurs in such regions as the abdominal cavity, the patient can be treated in a hyperbaric chamber, which contains a pressurized oxygen-rich atmosphere.

Reducing the susceptibility of infection will promote a better prognosis by practicing good hygiene and preventing the contraction of diseases which produce hypoxia or an immunocompromised state.

[citation needed] Following resolution of myonecrosis, patients will often require further care following the deleterious effects caused by the infection.

[20] With the best of care—including early recognition, surgical care, antibiotic treatment, and hyperbaric oxygen therapy—the mortality rate is 20-30% and can be as low as 5-10%.