Gangrene: -

Gangrene is necrosis and subsequent decay or death of body tissues or lack of

blood supply.
Causes: -

• Variety of chronic diseases e-g. DM (Diabetes mellitus).

• Injury insufficient blood supply.
• Bacteria.
• Post trauma
• Post surgery
• Infections

NOTE: It is a serious condition that requires immediate medical treatment.

Type: -

• Gas gangrene (a type of moist gangrene)

• Moist gangrene
• Dry gangrene

1- Gas gangrene: -

 Severe forms of gangrene (tissue death) usually caused by Clostridium

perfringers (an aerobe organism).
 It can also be form group “A” streptococcus, staphylococcus aureus.
 It is a bacterial infection that produces gas within tissues in gangrene
clostridium perfringers progress rapidly produce a gas and opens and
separate internal organs progressively tissues to infect.
 Gas gangrene can cause myonecrosis, gas production and sepsis.
Progression to toxemia and shock is often very rapid.
 It involves invasion of deep penetrating wound (in which blood supply
is compromised or no oxygen).
 Bacteria generate gas, puss and poisonous toxins as they grow.
 Most common in extremities.

Causes: -

• An aerobic organisms clostridium.

• Site of trauma or recent surgical wound.
• Arteriosclerosis.
• DM (Diabetes mellitus.
 Sign and symptoms: -

• Onset is sudden and dramatic.

• Pale to brownish red site of infection.
• Severe pain
• Swelling
• Shock like symptoms with decrease blood pressure.
• Fever
• Vesicle or blister
• Drainage from the tissue, foul smelling brown, red or blood fluid.
• Increase heart rate
• Sweating
• Crepitus (air in the tissue)

Diagnosis:

• Gram staining
• Blood culture
• X-rays
• CT Scan
• MRI

Treatment: -

• Revascularization (restoration of blood flow)

• Debridement
• Amputation
• Antibiotics
• Analgesics
• I/v fluid, blood transpusions, electrolytes
• Nutrition

Complication: -\

• Disfigurement
• Juindice with liver damage
• Kidney failure
• Sepsissepticemia
• Shock
• Coma

Preventions: -
 • Care of hand and feet of diabetic patient
• Abrasions, infections should be care immediately
• Antibiotics should begin early
• Dying skin should be removed promptly

2- Dry gangrene: -

 It is a condition that results when one or more arteries become

obstructed.
 In this type the tissue slowly dies due to lack of blood supply or no
blood supply.
 Blood flows are interrupted for a reason other than bacterial infection.
 The infected area becomes cold, begins to dry out and eventually drops
off over period of weeks or months.
 Most common in persons with advanced blockage of arteries resulting
from diabetes.
 Early signs dull ache, sensation of coldness in the area, polar of the
flesh.
 Later changing in colour to brown than black.
 Revascularization is done if caught early.
 It necrosis sets in affected tissue must be removed.

3- Moist gangrene: -

May occur in toes, feet or legs after a crushing injury or as a result of some
other factor that causes blood flow to the area to suddenly stop.
 When blood flow causes bacteria beg in to invade the muscle and
multiply quickly without interference from the body’s immune system.
 Organisms include streptococcus and staphylococcus.
 Moist and gas gangrene does not involve skin as much but usually only
the muscles.
 Sensation of heaviness in the affected region, severe pain, swelling,
crepitus foul smelling puss.