GANGRENE | Nursing Tutorials

The word “gangrene” comes from the Greek “ganggraina” denoting “an eating sore that ends in mortification”.
The death of body tissue due to the loss of blood supply to that tissue, sometimes permitting bacteria to invade it and accelerate its decay.
Gangrene is a complication of necrosis “cell death” characterized by the decay of body tissues, which become black and appearing “rotten”.
It is caused by infection or ischemia, such as a thrombosis.

GANGRENE… WHAT IS IT???

TYPES OF GANGRENE

DRY GANGRENE

The early signs are a dull ache and sensation of coldness in the affected are.
If caught early, the process can sometimes be reversed by vascular surgery.
If necrosis sets in, the affected tissue must be removed and treated like a case of wet gangrene.

WET GANGRENE

Wet gangrene occurs in naturally moist tissue and organs such as the mouth, bowel, lungs, cervix, and vulva.
Bedsores occurring on body parts such as the sacrum, buttocks and heels (not in “moist” areas) are also categorized as wet gangrene infections.
In wet gangrene, the tissue is infected by microorganisms, which cause tissue to swell and emit a fawol order.
Wet gangrene usually develops rapidly due to blockage of venous and/or arterial blood flow.
The affected part is saturated with stagnant blood which promotes the rapid growth of bacteria.
The toxic products formed by bacteria are absorbed causing systemic manifestation of bacteria and finally death.
The affected part is soft, putrid, rotten and dark.
The darkness in wet gangrene occurs due to the same mechanism as in dry gangrene.

GAS GANGRENE

Gas gangrene is a bacterial infection that produces gas within tissues.
It is a deadly form of gangrene usually caused by bacteria.
Infection spreads rapidly as the gases produced by bacteria expand and effect healthy tissue.
Gas gangrene is caused by environmental bacteria.
These Bacteria are mostly found in soil.
These environmental bacteria enter the muscle through a wound and cause necrotic tissue and powerful toxins.
These toxins destroy nearby tissue, generating gas at the same time.
Gas gangrene can cause necrosis, gas production, and sepsis.
Progression to toxemia and shock is often very rapid.
Because of its ability to quickly spread to surrounding tissues, gas gangrene should be treated as a medical emergency.

SPECIFIC GANGRENES

NOMA

Is a gangrenous disease leading to tissue destruction of the face, especially the mouth and cheek.
Risk factors include severe protein mal nutrition and unsanitary conditions.

NECROTIZING FASCIITIS

Commonly known as flesh-eating disease or flesh-eating bacteria.
Rare infection of the deeper layers of skin and easily spread within the subcutaneous tissue

FOURNIER GANGRENE

A type of necrotizing infection usually affecting the male genitals.
In the majority of cases it is a mixed infection caused by both aerobic and anaerobic bacteria

Prevention

Treatment

Removal of the Tissue.
In case of moist gangrene we can make scarification of Tissue. with knife or puncture the gangrenous Tissue.
to permit the escape of toxic liquid and allowing the introduction of antiseptic inside the lesion
Application of counter-irritant at the periphery of the affected part
This will cause increasing of hyperemia and phagocytosis near the affected Tissue.
Which accelerate the separation of the moist or dry gangrene from the health Tissue.
The best treatment of gangrene is amputation of the part from the body
High doses of antibiotic : Penicillin
The dead tissue is removed or limbs are amputated
No vaccine
10 megaunits of benzyl penicillin daily for 5 days as four 6 hourly doses Or Tetracycline 0.5 g intravenously or 1 g orally every 6 hours.
Clostridia not sensitive to metronidazole, some other anaerobic bacteria are, so give it.