Limb Ulceration and Gangrene - Gangrene Flashcards Preview

CVS (Vascular Surgery) > Limb Ulceration and Gangrene - Gangrene > Flashcards

Flashcards in Limb Ulceration and Gangrene - Gangrene Deck (13)
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1
Q

What is Wet Gangrene?

A

Infectious gangrene, including necrotising fasciitis, gas gangrene and gangrenous cellulitis.

2
Q

What is Necrotising Fasciitis?

A

Infection of the subcutaneous fascia and fat.

3
Q

How does wet gangrene present?

A

Poorly demarcated from surrounding tissue and septic/pyrexial patient.

4
Q

Management of wet gangrene (2).

A
  1. Surgical debridement.

2. Broad-Spectrum IV Antibiotics.

5
Q

What is Dry Gangrene?

A

Ischaemic gangrene.

6
Q

What is Dry Gangrene caused by (3)?

A

Chronically reduced blood flow :-

  1. Atherosclerosis (PAD).
  2. Thrombosis (Vasculitis, Hypercoagulability).
  3. Vasospasm (Cocaine, Raynaud’s).
7
Q

How does dry gangrene present?

A

Well demarcated from surrounding tissue and patient does not show signs of infection - auto-amputation may occur in most cases.

8
Q

Clinical Features of Gas Gangrene (5).

A
  1. Acute Onset of Severe Localised Pain.
  2. Darkened Skin.
  3. Spreading Erythema.
  4. Pyrexial.
  5. Infected area gives a distinctive potent smell.
9
Q

Pathophysiology of Gas Gangrene (4).

A
  1. Bacterial Growth - gas production.
  2. Greater Carbohydrate Breakdown by C. perfringens - gas and acid creation in affected area.
  3. Vegetative bacteria produce toxins and hydrolytic enzymes.
  4. Toxic shock - cell damage can cause systemic effects e.g. hypotension.
10
Q

Management of Gas Gangrene (4).

A
  1. Debridement urgently.
  2. Antibiotics.
  3. Amputation - Large margin (further development).
  4. Hyperbaric Oxygen Therapy - if bacteria are anaerobic.
11
Q

What is Fournier’s Gangrene?

A

A form of Necrotising Fasciitis affecting the perineum - urological emergency.

12
Q

Differentials of Fournier’s Gangrene (3).

A
  1. Cellulitis.
  2. Epididymo-Orchitis.
  3. Testicular Torsion.
13
Q

Management of Fournier’s Gangrene (3).

A
  1. Surgical Debirdement - Total/Partial Orchiectomy.
  2. Broad-Spectrum Antibiotics.
  3. Transfer to High-Dependency Setting.