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Flashcards in Gangrene Deck (23)
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What is gangrene

Gangrene is a serious condition where a loss of blood supply causes body tissue to die. It can affect any part of the body but typically starts in the toes, feet, fingers and hands.


What are the symptoms of gangrene

- redness and swelling in the affected area
- either a loss of sensation or severe pain in the affected area
- sores or blisters in the affected area that bleed or produce a foul-smelling pus


Who is infected with gangrene

- diabetes
- peripheral vascular disease
- atherosclerosis
- raynauds


What are the types of gangrene

- Dry gangrene
- Wet gangrene
- Gas gangrene


What causes gas gangrene

- Necrotising myositis caused by deep tissue infection with clostridium spp
- followed contaminated penetrating injuries
- seen in IV drug users and patients who have had abdominal surgery


How do you treat gas gangrene

- Remove all the dead tissue (e.g. Amputation)
- give benzylpenicillin +/- Clindamycin
- hyperbaric oxygen can improve survival and decrease the number of debridements


What is dry gangrene

- This is a type of gangrene is a form of coagulative necrosis that develops in ischemic tissue, where the blood supply is inadequate to keep tissue viable.


What can cause dry gangrene

- peripheral vascular disease
- acute limb ischemia
- high cholesterol
- diabetics
- smokers


How do you treat dry gangrene

restoration of blood supply +/- amputation


What is wet gangrene

Wet, or infected, gangrene is characterized by thriving bacteria and has a poor prognosis (compared to dry gangrene) due to sepsis resulting from the free communication between infected fluid and circulatory fluid


What causes wet gangrene to occur

- due to blockage venous or arterial blood flow
- the stagnant blood flow promotes the growth of bacteria
- can lead to sepsis and death


What can wet gangrene develop from

- injury
- dry gangrene
- embolism
- immune deficiency


What are the risk factors for gangrene development

- smoking
- obesity, diabetes, high blood pressure, and other causes of vascular disease
- excessive alcohol intake, which can lead to nerve damage
- impaired immune function, due for example, to HIV infection, chemotherapy, and radiation therapy
- intravenous drug use


What are the symptoms of gangrene

- skin discolouration
- swelling or the formation of blisters filled with fluid on the skin
- a clear line between healthy and damaged skin
- sudden, severe pain followed by a feeling of numbness
- foul smelling discharge leaking from a sore
- thin, shinny skin or skin without hair
- skin that feels cool or cold to the touch


What can cause gangrene

- lack of blood supply
- infection
- trauma


How do you treat gangrene

- Larval debridement surgery
- amputation
- antibiotics
- restore blood flow using bypass surgery and angioplasty
- skin graft


What are the symptoms of Gas gangrene

- myonecrosis
- muscle swelling
- gas production
- sepsis
- severe pain


What are the risk factors fo gas gangrene

- DM
- trauma
- malignancy


How do you treat wet gangrene

- Broad spectrum IV antibiotics
- surgical debridement
- +/- Amputation


What is necrotising fascilitis

- rapidly progressive infection of the deep fascia causing necrosis of SC tissue


How does necrotising facilitis present

- intense pain over affected skin and underlying muscle


What is the cause of necrotising facilitis

- group A beta-haemolytic streptococci
- often polymicrobial


What is the treatment if necrotising fasciitis

- radical debridement
- +/- amputation
- IV antibiotics