Highlights & Basics
- Gangrene is a complication of necrosis characterized by the decay of body tissues. Results from ischemia, infection, or trauma (or a combination of these processes).
- Two main categories: infectious gangrene (which includes necrotizing fasciitis and gas gangrene) and ischemic gangrene (which can arise from arterial or venous obstruction).
- Risk factors include diabetes, smoking, atherosclerosis, renal disease, drug and alcohol abuse, malignancy, trauma or abdominal surgery, contaminated wounds, malnutrition, hypercoagulable states, prolonged use of tourniquets, and community-acquired MRSA.
- Successful treatment of infectious gangrene requires early recognition and a combination of aggressive surgical debridement, appropriate intravenous antibiotics, and intensive supportive care.
- Ischemic gangrene requires revascularization for obstruction and thromboembolism, along with optimal treatment of any underlying disease. Measures to prevent superimposed infection must also be performed.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Necrotizing fasciitis I subtype involving genital and perineal region; image taken after extensive surgical debridement
Eschar and blister formation with notable edema in diabetic patient who developed gas gangrene after a lower limb trauma
Ischemic gangrene secondary to antiphospholipid syndrome
Hemorrhagic blister formation secondary to ischemic gangrene
Newborn with purpura fulminans due to Streptococcus B hemolyticus
Eschar surrounded by erythema, edema, and hemorrhagic blisters
Citations
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Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America. Clin Infect Dis. 2014 Jul 15;59(2):e10-52.[Abstract][Full Text]
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Bradbury AW, Adam DJ, Bell J, et al; BASIL trial Participants. Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial: an intention-to-treat analysis of amputation-free and overall survival in patients randomized to a bypass surgery-first or a balloon angioplasty-first revascularization strategy. J Vasc Surg. 2010 May;51(5 Suppl):5-17S.[Abstract]
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