Gangrene Flashcards
What types of gangrene are there?
Wet
Dry
What is gangrene?
Irreversible tissue death from poor vascular supply
What is wet gangrene?
Tissue death + infection
Putrefied, ill defined
What is dry gangrene?
Tissue death only
Dry and shrunken
Well demarcated
Features of PVD
What are the causes of gangrene?
DM
Embolism and thrombosis e.g. foot trash (AAA repair)
Raynaud’s
Thromboangiitis obliterans (Buerger’s disease)
Injury: extreme cold, heat, trauma, pressure
What is the management of gangrene?
Ix: Take cultures
Medical: Benpen ± clindamycin
Surgical: Debridement (including amputation)
What is synergistic gangrene?
Aerobes + anaerobes
E.g. Fournier’s, Meleney’s
Progress rapidly to nec fasc and myositis
What is Fournier’s gangrene?
Gangrene of the perineum
Most common in immunocompromised states e.g. DM, ETOHics
What is Meleney’s gangrene?
Post-operative ulceration
What is gas gangrene?
Clostridium perfringens myositis
What are risk factors for gas gangrene?
DM
Trauma
Malignancy
How would gas gangrene present?
Toxaemia
Crepitus from surgical emphysema
Bubbly brown pus
How would you treat gas gangrene?
Debridement ± amputation
Benpen + metronidazole
Hyperbaric O2
