GANGRENE

  • 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???

  • It is usually the result of critically insufficient blood supply.
  • Often associated with diabetes and long-term smoking.
  • Condition is most common in the lower extremities.
  • Basically Your Blood Supply Gets Cut Off And Your Tissue Decides To Die

TYPES OF GANGRENE

  1. DRY GANGRENE
  2. WET GANGRENE
  3. GAS 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 gangrene of the face.
  • Necrotizing fasciitis affects the deeper layers of the skin.
  • Fournier gangrene usually affects the male genitals.

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

  • Cleaning the wound
  • Avoid the contaminated material
  • Improve circulation in patients with poor circulation
  • Antitoxin

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.

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