Gangrene

Question 1

What is gangrene?

Answer 1

Death of tissue from poor vascular supply and is a sign of critical limb ischaemia. Tissues are black.

Question 2

What is this describing and how is it treated?

Tissue necrosis in the absence of infection.

Answer 2

1. Dry gangrene

2. Restoration of blood supply +/- amputation

Question 3

What is this describing and how is it treated?

Tissue necrosis with infection.

Answer 3

1. Wet gangrene

2. Analgesia, IV antibiotics +/- amputation

Question 4

What is this describing and how is it treated?
Tissue necrosis caused by spore forming clostridial species. Rapid onset muscle swelling, sepsis and severe pain. Trauma, DM and/or malignancy in background.

Answer 4

1. Gas gangrene

2. IV antibiotics, amputation, hyperbaric oxygen

Question 5

What is this describing?

Tissue necrosis localised to the scrotum and perineum.

Answer 5

Fournier’s gangrene

Question 6

What is this describing and how is it treated?
Rapidly progressive infection of the deep fascia, hard to recognise in early stages. Acute onset, rapidly worsening cellulitis with pain out of keeping with physical features.

Answer 6

1. Necrotising fasciitis

2. Urgent surgical debridement, IV antibiotics +/- amputation.