Arterial.12.Gangrene Flashcards
(50 cards)
Gangrene
- DEFINITION
- CARDINAL SIGNS
- ETIOLOGY
- CLINICAL TYPES
DEFINITION of Gangrene
macroscopic death of tissues that is
generally caused by loss of blood supply and is usually associated with bacterial invasion and putrefaction
CARDINAL SIGNS of Gangrene
- mnemonic
- List
- Threatened Gangrene
mnemonic for CARDINAL SIGNS of Gangrene
Press and See How Color Fades
List of CARDINAL SIGNS of Gangrene
The five cardinal signs of local death are:
- Loss of pulsation and sluggish capillary circulation.
- Loss of sensation.
- Loss of heat “Cold extremity unless infected”.
- Fixed skin color change
- Loss of function “paralyzed extremity”.
Fixed skin color change in Gangrene in List of CARDINAL SIGNS of Gangrene
- Change of skin color into blue and later black :
* The color does not change by local pressure.
Threatened Gangrene in CARDINAL SIGNS of Gangrene
- Patients suffering from threatened gangrene have all CARDINAL SIGNS of Gangrene
- but tissues are still viable and local Pressure Causes some modification of Color which returns when the Pressure is released.
ETIOLOGY of Gangrene
- Ischemic
- Neuropathic :
- Traumatic
- Physico-chemical
- Infective:
- Venous gangrene.
Ischemic ETIOLOGY of Gangrene
- Thrombosis: On top of atherosclerosis (senile gangrene).
- Embolism
- Vasospastic disease: Raynaud’s disease
Senile gangrene in Ischemic ETIOLOGY of Gangrene
ischemic gangrene caused by Thrombosis On top of atherosclerosis
Neuropathic ETIOLOGY of Gangrene
- Diabetes Mellitus
* leprosy
Traumatic ETIOLOGY of Gangrene
Direct trauma: Due to crushing or pressure (bed sores).
- Indirect trauma: Due to injury of the main vessels.
Physico-chemical ETIOLOGY of Gangrene
- Burns
- Frost-bite
- Trench foot
Frost-bite in Physico-chemical ETIOLOGY of Gangrene
Damage to tissues as the result of exposure to low environmental temperatures, also called congelation
Trench foot in Physico-chemical ETIOLOGY of Gangrene
a type of immersion foot resembling frostbite caused by prolonged action of cold water on the skin combined with circulatory disturbance due to cold and inaction
Infective ETIOLOGY of Gangrene
- Specific infection:
2. Non-specific infections
Specific infection in Infective ETIOLOGY of Gangrene
Clostridial gas gangrene
Nonspecific infections in Infective ETIOLOGY of Gangrene
As carbuncle, anaerobic cellulitis
CLINICAL TYPES of Gangrene
l - Dry Gangrene
II- Moist aseptic gangrene
II- Moist septic gangrene
IV- Special Types of gangrene :
A. Decubitus ulcer : Look plastic.
B. Idiopathic gangrene of the scrotum
Dry gangrene in CLINICAL TYPES of Gangrene
- Etiology and pathogenesis
- Clinical picture
- Management
Etiology and pathogenesis of Dry gangrene in CLINICAL TYPES of Gangrene
Chronic ischemia as gradual slowing of the blood flow permits free evaporation from the affected surface & for venous & lymphatic drainage.
Clinical picture of Dry gangrene in CLINICAL TYPES of Gangrene
- Hard.
- Dry.
- Wrinkled and shrunken
- Line of demarcation
- Line of separation
Line of demarcation in Clinical picture of Dry gangrene in CLINICAL TYPES of Gangrene
a. A zone of demarcation between the truly viable and the dead or dying tissue, indicated on the surface by a band of hyperemia and by hyperesthesia.
b- In the absence of infection, the dead part is cast off by a process of ulceration at the expense of the dead tissue which is invaded by granulation tissue extending from the living tissues.
Line of separation of Dry gangrene in CLINICAL TYPES of Gangrene
a. The granulation tissue advances until its blood supply cannot cope with further growth.
b. The line of separation thus lies distal to the line of demarcation and the resulting stump is conical.
