Gangrene

Question 1

Define Gangrene

Answer 1

Death of tissue from poor vascular supply

can be ischemic (Dry) -often critical ischemia or infectious (wet)

Question 2

aetiology and risk factors of Gangrene

Answer 2

Ischemic-mainly atherosclerosis, leading to bad blood flow to areas as the arteries narrow

Infectious-necrotising fascitiis or Gas gangrene (spore forming clostridial species)

Risk factors for dry-diabetes, malignancy, smoking, atherosclerosis, hypercoagulable states

Wet gangrene-Diabetes, surgery, contaminated wounds, alcohol, renal issue, immunosuppression and malignancies

Question 3

Epidemology of Gangrene

Answer 3

US-3000 cases anually-rare

lot more common for those WITH artherosclerosis

Question 4

Symptoms and signs of Gangrene

Answer 4

Symptoms- Risk factors
Pain (chronic claudication or sudden onset)
oedema/swelling of area
Rarer-skin coloration (purple/black
Crepitus-gas gangrene
discharge (infective)

Signs:
ischemic-reduced pedal and ankle pulses, cold 
tissues may slough
extremities
demarcation between living and dead

Infectious-warmth, low grade fever and chills

Question 5

Investigations of Gangrene

Answer 5

Bloods-WBC high
Sodium LOW
Lacate high
CRP high
Blood cultures

Xray-specific for gas gangrene–gas in the soft tissues +/- osteomyelitis
CT/MRI-swelling, gas, tick fascia,
doppler-artery block

skin biopsy

Differential-cellulitis, DVT, Staph infection