Gangrene

Question 1

Define Gangrene

Answer 1

Death of tissue due to poor vascular supply.

Question 2

What are the different types of Gangrene?

Answer 2

Dry: tissue death only
Wet: tissue death + infection
Pregangrene: tissue on the brink of gangrene

Question 3

How does Gangrene usually present?

Answer 3

Black tissues
Slough
May be suppuration (pus forms)/sepsis

Question 4

What micro-organism causes Gas gangrene?

Answer 4

Clostridium perfringes

Question 5

Define Gas gangrene

Answer 5

Clostridium perfringes myositis (inflammation/degeneration of muscle tissue)

Question 6

What are some of the risk factors for Gas gangrene?

Answer 6

DM
Trauma
Malignancy

Question 7

How does Gas gangrene usually present?

Answer 7

Toxaemia
Haemolytic jaundice
Oedema
Crepitus from surgical emphysema
Bubbly brown pus

Question 8

What is the management of Gas gangrene?

Answer 8

Debridement (may need amputation)
Benzylpenicillin + metronidazole
Hyperbaric O2

Question 9

What is Synergistic gangrene?

Answer 9

Mix of aerobes + anaerobes. Can progress rapidly to necrotising fasciitis + myositis

Question 10

What is the management of Synergistic gangrene?

Answer 10

Take cultures
Debridement (including amputation)
Benzylpenicillin ± clindamycin