Condition- Gangrene + Necrotising Fasciitis Flashcards
What is gangrene?
Tissue necrosis due to poor vascular supply
What are the two classifications of gangrene and what do they imply?
Wet Gangrene= tissue necrosis + infection
Dry gangrene= tissue necrosis
List some causes of gangrene
Ischaemia (usually critical limb ischaemia= subset of chronic PVD) , Infection, Trauma (ulcers, punctyre/surgical wounds)
Which group of organisms tend to cause gas gangrene?
Clostridials: Clostrium Perfringens
List some risk factors for developing gangrene
- Ischaemic
- PVD
- Diabetes
- Smoking
- Leg ulcers
- Infective
- Immunosuppression
- Steroid use
- Puncture/ surgical wound
- Trauma
- Malignancy
List some of the presenting symptoms/ features of wet gangrene…
- Pain
- Boggy, Blackening of area
- often extremities
- May become purulent + have foul odour
List some of the signs and symptoms of gas gangrene
- Muscle swelling, sepsis, severe pain
- Erythema and oedema
- Crepitus
List some investigations you can conduct on a patient with gangrene
- BLOODS: FBC, U&Es, glucose, CRP and blood culture
- WOUND:
- wound swab
- pus/fluid aspirate
- MC&S
- X-ray of affected area
What is necrotising fasciitis?
A life-threatening infection of deep fascia causing necrosis of SC tissue
List some of the common causative bacteria for necrotising fasciitis.
Staph A and group A Strep
What are the two types of necrotising fasciitis?
- Type 1: caused by mix of aerobes and anaerobes (most common)
- Type 2: caused by Strep Pyogenes
List some of the presenting symptoms of necrotising fasciitis
- Sudden onset
- Severe pain out of proportion to physical appearance
- Some redness and swelling over area
- Predisposing event (trauma, ulcer, surgery)
List some of the signs of necrotising fasciitis on physical examination
- Tenderness
- Erthematous area + oedema
- Haemorrhagic blisters may be present
- Signs of systemic response + sepsis (fever, tachycardia, tachyopnoea, hypotension)
