Gangrene - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

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.

Ischemic gangrene secondary to antiphospholipid syndrome

Collection of Jose Contreras-Ruiz (Clinica del Cuidado Integral de Heridas y Estomas)

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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

Key Articles

Kihiczak GG, Schwartz RA, Kapila R. Necrotizing fasciitis: a deadly infection. J Eur Acad Dermatol Venereol. 2006 Apr;20(4):365-9.[Abstract][Full Text]
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]
Nicolasora N, Kaul DR. Infectious disease emergencies. Med Clin North Am. 2008 Mar;92(2):427-41.[Abstract]
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]
Norgren L, Hiatt WR, Dormandy JA, et al.; TASC II Working Group. Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg. 2007 Jan;45 Suppl S:S5-67.[Abstract][Full Text]

Referenced Articles

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