Gangrene Flashcards
How does wet gangrene present?
Present with symptoms of fever and sepsis
Bullae formation and poorly demarcated necrotic area
Foul-smelling odour
Oedema of organs affected
Liquefaction, more common in bowel, cervix and appendix
What is the cause of dry gangrene?
Arterial occlusion
-> it is more common than dry gangrene
Why does wet gangrene occur?
Due to venous occlusion from:
->Infection
->Gangrenous cellulitis
-> Gas gangrene
How does dry gangrene present?
Cold and pale area, with well-demarcated necrosis
->autoamputation is typical indicated
What are the investigations for wet gangrene?
FBC with inflammatory makers
Lactic acid to assess severity
Imaging with X ray or CT
Tissue biospy
What is gas gangrene caused by?
Clostridium perfingens, which is lined to wet gangrene.
What is the cause of necrotising fasciitis?
Streptococcus pyogenes, and is typically poylmycrobial
What are the risk factors for wet gangrene?
Immunocompromise
Diabetes mellitus
Older age
Trauma to the skin (which enables entry of the microbial into the tissue)
What are the risks with factors for dry gangrene?
Peripheral arterial disease
Thrombosis
Vasospasms inked to cocaine or Raynaud’s
Extreme cold injury
Embolism
Venous insufficiency
What are the investigations for dry gangrene?
Doppler ultrasound or angiography
Glucose level to evaluate for diabetes
Coagulation profile for suspected hypercoagulablity
What is the management of we gangrene?
Analgesia
Surgical debridement
Broad spectrum antibiotics
What is the management of dry gangrene?
Amputation
Hyperbaric oxygen therapy to encourage healing
Amputation
When is auto-amputation likely?
Dry gangrene
