Gangrene.docx

7/25/2019 Gangrene.docx

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Gangrene

From Wikipedia, the free encyclopedia

Gangrene

Dry gangrene affecting the toes as a result of

peripheral artery disease.

Classification and external resources

Specialty Infectious disease,general surgery

ICD-10 R02, I70.2, E0.2, I7!."

ICD-9-CM 0#0.0, 7$%.#

DiseasesDB "27!

MedlinePlus 0072$

eMedicine

article&27"#!article&7$270"

article&2#""2article!$""#article&202$$""article&20%%7

Patient U 'angrene

MeS! D00%7!#

(edit on Wikidata)

Gangrene*or gangrenous necrosis+ is a type of necrosiscaused y a critically insufficient

lood supply.()(2)-his potentially lifethreatening condition may occur after an in/ury or

infection, or in people suffering from any chronic health prolem affectinglood circulation.(2)

-he primary cause of gangrene is reducedlood supplyto the affected tissues, hich results incelldeath.(!)Diaetesand longterm smoking increase the risk of suffering from gangrene.(2)(!)

'angrene is a noncommunicale disease. It does not spread from person to person. -here are

different types of gangrene ith different symptoms, such as dry gangrene,et gangrene,gas

gangrene, internal gangreneand necroti1ing fasciitis.()(2)-reatment depends on the underlyingcause, and can include resection,deridement*or, in seere cases, amputation+ of the affected

ody parts, antiiotics,reasculari1ation*ia a ascular ypassor angioplasty+, or hyperaric
https://en.wikipedia.org/wiki/Peripheral_artery_diseasehttps://en.wikipedia.org/wiki/Specialty_(medicine)https://en.wikipedia.org/wiki/Infectious_disease_(medical_specialty)https://en.wikipedia.org/wiki/General_surgeryhttps://en.wikipedia.org/wiki/General_surgeryhttps://en.wikipedia.org/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problemshttps://en.wikipedia.org/wiki/ICD-10http://apps.who.int/classifications/icd10/browse/2015/en#/R02http://apps.who.int/classifications/icd10/browse/2015/en#/I70.2http://apps.who.int/classifications/icd10/browse/2015/en#/E10.2http://apps.who.int/classifications/icd10/browse/2015/en#/I73.9https://en.wikipedia.org/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problemshttps://en.wikipedia.org/wiki/List_of_ICD-9_codeshttp://www.icd9data.com/getICD9Code.ashx?icd9=040.0http://www.icd9data.com/getICD9Code.ashx?icd9=785.4https://en.wikipedia.org/wiki/Diseases_Databasehttp://www.diseasesdatabase.com/ddb19273.htmhttps://en.wikipedia.org/wiki/MedlinePlushttp://www.nlm.nih.gov/medlineplus/ency/article/007218.htmhttps://en.wikipedia.org/wiki/EMedicinehttp://emedicine.medscape.com/article/217943-overviewhttp://emedicine.medscape.com/article/782709-overviewhttp://emedicine.medscape.com/article/214992-overviewhttp://emedicine.medscape.com/article/438994-overviewhttp://emedicine.medscape.com/article/2028899-overviewhttp://emedicine.medscape.com/article/2051157-overviewhttps://en.wikipedia.org/wiki/Patient_UKhttp://patient.info/doctor/gangrenehttps://en.wikipedia.org/wiki/Medical_Subject_Headingshttps://www.nlm.nih.gov/cgi/mesh/2016/MB_cgi?field=uid&term=D005734https://www.wikidata.org/wiki/Q168805https://en.wikipedia.org/wiki/Necrosishttps://en.wikipedia.org/wiki/Gangrene#cite_note-Porth-1https://en.wikipedia.org/wiki/Gangrene#cite_note-Porth-1https://en.wikipedia.org/wiki/Gangrene#cite_note-nhsintro-2https://en.wikipedia.org/wiki/Blood_circulationhttps://en.wikipedia.org/wiki/Gangrene#cite_note-nhsintro-2https://en.wikipedia.org/wiki/Gangrene#cite_note-nhsintro-2https://en.wikipedia.org/wiki/Perfusionhttps://en.wikipedia.org/wiki/Cell_(biology)https://en.wikipedia.org/wiki/Cell_(biology)https://en.wikipedia.org/wiki/Gangrene#cite_note-nhscause-3https://en.wikipedia.org/wiki/Diabeteshttps://en.wikipedia.org/wiki/Diabeteshttps://en.wikipedia.org/wiki/Gangrene#cite_note-nhsintro-2https://en.wikipedia.org/wiki/Gangrene#cite_note-nhscause-3https://en.wikipedia.org/wiki/Dry_gangrenehttps://en.wikipedia.org/wiki/Dry_gangrenehttps://en.wikipedia.org/wiki/Wet_gangrenehttps://en.wikipedia.org/wiki/Gas_gangrenehttps://en.wikipedia.org/wiki/Gas_gangrenehttps://en.wikipedia.org/wiki/Gas_gangrenehttps://en.wikipedia.org/wiki/Internal_gangrenehttps://en.wikipedia.org/wiki/Necrotizing_fasciitishttps://en.wikipedia.org/wiki/Necrotizing_fasciitishttps://en.wikipedia.org/wiki/Gangrene#cite_note-Porth-1https://en.wikipedia.org/wiki/Gangrene#cite_note-nhsintro-2https://en.wikipedia.org/wiki/Resection_(surgery)https://en.wikipedia.org/wiki/Resection_(surgery)https://en.wikipedia.org/wiki/Debridementhttps://en.wikipedia.org/wiki/Debridementhttps://en.wikipedia.org/wiki/Amputationhttps://en.wikipedia.org/wiki/Antibioticshttps://en.wikipedia.org/wiki/Revascularizationhttps://en.wikipedia.org/wiki/Revascularizationhttps://en.wikipedia.org/wiki/Revascularizationhttps://en.wikipedia.org/wiki/Vascular_bypasshttps://en.wikipedia.org/wiki/Angioplastyhttps://en.wikipedia.org/wiki/Hyperbaric_oxygen_therapyhttps://en.wikipedia.org/wiki/Specialty_(medicine)https://en.wikipedia.org/wiki/Infectious_disease_(medical_specialty)https://en.wikipedia.org/wiki/General_surgeryhttps://en.wikipedia.org/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problemshttps://en.wikipedia.org/wiki/ICD-10http://apps.who.int/classifications/icd10/browse/2015/en#/R02http://apps.who.int/classifications/icd10/browse/2015/en#/I70.2http://apps.who.int/classifications/icd10/browse/2015/en#/E10.2http://apps.who.int/classifications/icd10/browse/2015/en#/I73.9https://en.wikipedia.org/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problemshttps://en.wikipedia.org/wiki/List_of_ICD-9_codeshttp://www.icd9data.com/getICD9Code.ashx?icd9=040.0http://www.icd9data.com/getICD9Code.ashx?icd9=785.4https://en.wikipedia.org/wiki/Diseases_Databasehttp://www.diseasesdatabase.com/ddb19273.htmhttps://en.wikipedia.org/wiki/MedlinePlushttp://www.nlm.nih.gov/medlineplus/ency/article/007218.htmhttps://en.wikipedia.org/wiki/EMedicinehttp://emedicine.medscape.com/article/217943-overviewhttp://emedicine.medscape.com/article/782709-overviewhttp://emedicine.medscape.com/article/214992-overviewhttp://emedicine.medscape.com/article/438994-overviewhttp://emedicine.medscape.com/article/2028899-overviewhttp://emedicine.medscape.com/article/2051157-overviewhttps://en.wikipedia.org/wiki/Patient_UKhttp://patient.info/doctor/gangrenehttps://en.wikipedia.org/wiki/Medical_Subject_Headingshttps://www.nlm.nih.gov/cgi/mesh/2016/MB_cgi?field=uid&term=D005734https://www.wikidata.org/wiki/Q168805https://en.wikipedia.org/wiki/Necrosishttps://en.wikipedia.org/wiki/Gangrene#cite_note-Porth-1https://en.wikipedia.org/wiki/Gangrene#cite_note-nhsintro-2https://en.wikipedia.org/wiki/Blood_circulationhttps://en.wikipedia.org/wiki/Gangrene#cite_note-nhsintro-2https://en.wikipedia.org/wiki/Perfusionhttps://en.wikipedia.org/wiki/Cell_(biology)https://en.wikipedia.org/wiki/Gangrene#cite_note-nhscause-3https://en.wikipedia.org/wiki/Diabeteshttps://en.wikipedia.org/wiki/Gangrene#cite_note-nhsintro-2https://en.wikipedia.org/wiki/Gangrene#cite_note-nhscause-3https://en.wikipedia.org/wiki/Dry_gangrenehttps://en.wikipedia.org/wiki/Wet_gangrenehttps://en.wikipedia.org/wiki/Gas_gangrenehttps://en.wikipedia.org/wiki/Gas_gangrenehttps://en.wikipedia.org/wiki/Internal_gangrenehttps://en.wikipedia.org/wiki/Necrotizing_fasciitishttps://en.wikipedia.org/wiki/Gangrene#cite_note-Porth-1https://en.wikipedia.org/wiki/Gangrene#cite_note-nhsintro-2https://en.wikipedia.org/wiki/Resection_(surgery)https://en.wikipedia.org/wiki/Debridementhttps://en.wikipedia.org/wiki/Amputationhttps://en.wikipedia.org/wiki/Antibioticshttps://en.wikipedia.org/wiki/Revascularizationhttps://en.wikipedia.org/wiki/Vascular_bypasshttps://en.wikipedia.org/wiki/Angioplastyhttps://en.wikipedia.org/wiki/Hyperbaric_oxygen_therapyhttps://en.wikipedia.org/wiki/Peripheral_artery_disease


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o3ygen therapy.(#)It can rarely include medical therapy to stop ascular spasmor the production

of coldinduced ascular ostruction y coldprecipitated cryogloulins.

Contents

Etymology

2 4auses

! -ypes

o !. Dry

o !.2 Wet

o !.! 'as

o !.# 5ther

# -reatment

% 6istory

8ee also

7 References

$ E3ternal links

"ty#ology

-he etymologyof gangrene deries from the9atinordgangraenaand from the 'reek

gangraina*:;::?=+, hich means @putrefactionof tissues@. It has no etymological connectionith the ord green,despite the affected areas turning lack and&or green and&or yelloish

ron. It is coincidence that, in9oland 8cotsthe ords @gang green@ *go green+ can e said to

e an eggcornfor gangrene, as it descries the symptoms of the affliction.

Causes

'angrene is caused y a critically insufficient lood supply *e.g.,peripheral ascular disease+ or

infection.(!)(%)()It is associated ith diaetes(7)and longterm toacco smoking. -his condition

most commonly occurs in the loer e3tremities*legs and feet+.
https://en.wikipedia.org/wiki/Hyperbaric_oxygen_therapyhttps://en.wikipedia.org/wiki/Hyperbaric_oxygen_therapyhttps://en.wikipedia.org/wiki/Gangrene#cite_note-nhstreat-4https://en.wikipedia.org/wiki/Vasospasmhttps://en.wikipedia.org/wiki/Cryoglobulinhttps://en.wikipedia.org/wiki/Gangrene#Etymologyhttps://en.wikipedia.org/wiki/Gangrene#Causeshttps://en.wikipedia.org/wiki/Gangrene#Typeshttps://en.wikipedia.org/wiki/Gangrene#Typeshttps://en.wikipedia.org/wiki/Gangrene#Dryhttps://en.wikipedia.org/wiki/Gangrene#Wethttps://en.wikipedia.org/wiki/Gangrene#Gashttps://en.wikipedia.org/wiki/Gangrene#Otherhttps://en.wikipedia.org/wiki/Gangrene#Treatmenthttps://en.wikipedia.org/wiki/Gangrene#Historyhttps://en.wikipedia.org/wiki/Gangrene#See_alsohttps://en.wikipedia.org/wiki/Gangrene#Referenceshttps://en.wikipedia.org/wiki/Gangrene#External_linkshttps://en.wikipedia.org/wiki/Etymologyhttps://en.wikipedia.org/wiki/Latinhttps://en.wikipedia.org/wiki/Latinhttps://en.wikipedia.org/wiki/Greek_languagehttps://en.wikipedia.org/wiki/Greek_languagehttps://en.wikipedia.org/wiki/Putrefactionhttps://en.wikipedia.org/wiki/Putrefactionhttps://en.wikipedia.org/wiki/Greenhttps://en.wikipedia.org/wiki/Greenhttps://en.wikipedia.org/wiki/Scots_languagehttps://en.wikipedia.org/wiki/Scots_languagehttps://en.wikipedia.org/wiki/Scots_languagehttps://en.wikipedia.org/wiki/Eggcornhttps://en.wikipedia.org/wiki/Eggcornhttps://en.wikipedia.org/wiki/Peripheral_vascular_diseasehttps://en.wikipedia.org/wiki/Gangrene#cite_note-nhscause-3https://en.wikipedia.org/wiki/Gangrene#cite_note-5https://en.wikipedia.org/wiki/Gangrene#cite_note-Yang-6https://en.wikipedia.org/wiki/Diabeteshttps://en.wikipedia.org/wiki/Diabeteshttps://en.wikipedia.org/wiki/Gangrene#cite_note-7https://en.wikipedia.org/wiki/Gangrene#cite_note-7https://en.wikipedia.org/wiki/Human_leghttps://en.wikipedia.org/wiki/Hyperbaric_oxygen_therapyhttps://en.wikipedia.org/wiki/Gangrene#cite_note-nhstreat-4https://en.wikipedia.org/wiki/Vasospasmhttps://en.wikipedia.org/wiki/Cryoglobulinhttps://en.wikipedia.org/wiki/Gangrene#Etymologyhttps://en.wikipedia.org/wiki/Gangrene#Causeshttps://en.wikipedia.org/wiki/Gangrene#Typeshttps://en.wikipedia.org/wiki/Gangrene#Dryhttps://en.wikipedia.org/wiki/Gangrene#Wethttps://en.wikipedia.org/wiki/Gangrene#Gashttps://en.wikipedia.org/wiki/Gangrene#Otherhttps://en.wikipedia.org/wiki/Gangrene#Treatmenthttps://en.wikipedia.org/wiki/Gangrene#Historyhttps://en.wikipedia.org/wiki/Gangrene#See_alsohttps://en.wikipedia.org/wiki/Gangrene#Referenceshttps://en.wikipedia.org/wiki/Gangrene#External_linkshttps://en.wikipedia.org/wiki/Etymologyhttps://en.wikipedia.org/wiki/Latinhttps://en.wikipedia.org/wiki/Greek_languagehttps://en.wikipedia.org/wiki/Putrefactionhttps://en.wikipedia.org/wiki/Greenhttps://en.wikipedia.org/wiki/Scots_languagehttps://en.wikipedia.org/wiki/Eggcornhttps://en.wikipedia.org/wiki/Peripheral_vascular_diseasehttps://en.wikipedia.org/wiki/Gangrene#cite_note-nhscause-3https://en.wikipedia.org/wiki/Gangrene#cite_note-5https://en.wikipedia.org/wiki/Gangrene#cite_note-Yang-6https://en.wikipedia.org/wiki/Diabeteshttps://en.wikipedia.org/wiki/Gangrene#cite_note-7https://en.wikipedia.org/wiki/Human_leg


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$ypes

Dry

Dry gangrene is a form of coagulatie necrosisthat deelops in ischemictissue, here the lood

supply is inadeAuate to keep tissue iale. Dry gangrene is often due toperipheral artery disease,

ut can e due to acute lim ischemia. -he limited o3ygen in the ischemic lim limitsputrefactionand acteria fail to surie. -he affected part is dry, shrunken and dark reddish

lack. -he line of separation usually rings aout complete separation, ith eentual falling off

of the gangrenous tissue if it is not remoed surgically, a process called autoamputation.

Dry gangrene is the end result of chronic ischemiaithoutinfection.If ischemia is detectedearly, hen there are ischemic oundsrather than gangrene, the process can e treated y

reasculari1ation*iaascular ypassor angioplasty+.(medical citation needed)6oeer, once gangrene

has deeloped, the affected tissues are not salageale.(medical citation needed)

Diaetes mellitusis a riskfactor for peripheral ascular disease and thus for dry gangrene, utalso a risk factor for et gangrene, particularly in patients ith poorly controlled loodsugars,

as eleated serum glucose creates a faorale enironment for acterial infection.($)

%et

Wet, or infected, gangrene is characteri1ed y thriing acteria and has a poorprognosis

*compared to dry gangrene+ due to sepsisresulting from the free communication eteen

infected fluid and circulatory fluid. In et gangrene, the tissue is infected y saprogenicmicroorganisms *Clostridium perfringensorBacillus fusiformis, for e3ample+, hich cause

tissue to sell and emit a fetidsmell. Wet gangrene usually deelops rapidly due to lockage of

enous *mainly+ and&or arterial lood flo. -he affected part is saturated ith stagnant lood,hich promotes the rapid groth of acteria. -he to3ic products formed y acteria are

asored, causing systemic manifestation of sepsis and finally death. -he affected part is

edematous, soft, putrid, rotten and dark.

Because of the high mortality associated ith infected gangrene, an emergency salageamputation, such as a guillotine amputation,is often needed to limit systemic effects of the

infection.(")8uch an amputation can e conerted to a formal amputation, such as aeloor

aoe knee amputation.(")

Gas

Cain article 'as gangrene

'as gangrene is a acterial infection that produces gas ithin tissues. It can e caused y

Clostridium, most commonly alpha to3inproducing Clostridium perfringens, or arious nonclostridial species.()(0)Infection spreads rapidly as the gases produced y acteria e3pand and
https://en.wikipedia.org/wiki/Coagulative_necrosishttps://en.wikipedia.org/wiki/Ischemiahttps://en.wikipedia.org/wiki/Tissue_(biology)https://en.wikipedia.org/wiki/Tissue_(biology)https://en.wikipedia.org/wiki/Peripheral_artery_diseasehttps://en.wikipedia.org/wiki/Peripheral_artery_diseasehttps://en.wikipedia.org/wiki/Acute_limb_ischemiahttps://en.wikipedia.org/wiki/Putrefactionhttps://en.wikipedia.org/wiki/Autoamputationhttps://en.wikipedia.org/wiki/Ischemiahttps://en.wikipedia.org/wiki/Infectionhttps://en.wikipedia.org/wiki/Infectionhttps://en.wikipedia.org/wiki/Infectionhttps://en.wikipedia.org/wiki/Ischemic_woundhttps://en.wikipedia.org/wiki/Revascularizationhttps://en.wikipedia.org/wiki/Vascular_bypasshttps://en.wikipedia.org/wiki/Vascular_bypasshttps://en.wikipedia.org/wiki/Vascular_bypasshttps://en.wikipedia.org/wiki/Angioplastyhttps://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(medicine)https://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(medicine)https://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(medicine)https://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(medicine)https://en.wikipedia.org/wiki/Diabetes_mellitushttps://en.wikipedia.org/wiki/Gangrene#cite_note-8https://en.wikipedia.org/wiki/Prognosishttps://en.wikipedia.org/wiki/Sepsishttps://en.wikipedia.org/wiki/Putrefying_bacteriahttps://en.wikipedia.org/wiki/Putrefying_bacteriahttps://en.wikipedia.org/wiki/Clostridium_perfringenshttps://en.wikipedia.org/wiki/Bacillus_fusiformishttps://en.wikipedia.org/wiki/Fetidhttps://en.wikipedia.org/wiki/Guillotine_amputationhttps://en.wikipedia.org/wiki/Guillotine_amputationhttps://en.wikipedia.org/wiki/Gangrene#cite_note-CochAmp-9https://en.wikipedia.org/wiki/Below_knee_amputationhttps://en.wikipedia.org/wiki/Above_knee_amputationhttps://en.wikipedia.org/wiki/Above_knee_amputationhttps://en.wikipedia.org/wiki/Gangrene#cite_note-CochAmp-9https://en.wikipedia.org/wiki/Gas_gangrenehttps://en.wikipedia.org/wiki/Clostridiumhttps://en.wikipedia.org/wiki/Clostridium_perfringens_alpha_toxinhttps://en.wikipedia.org/wiki/Clostridium_perfringenshttps://en.wikipedia.org/wiki/Gangrene#cite_note-Yang-6https://en.wikipedia.org/wiki/Gangrene#cite_note-Sakurai-10https://en.wikipedia.org/wiki/Coagulative_necrosishttps://en.wikipedia.org/wiki/Ischemiahttps://en.wikipedia.org/wiki/Tissue_(biology)https://en.wikipedia.org/wiki/Peripheral_artery_diseasehttps://en.wikipedia.org/wiki/Acute_limb_ischemiahttps://en.wikipedia.org/wiki/Putrefactionhttps://en.wikipedia.org/wiki/Autoamputationhttps://en.wikipedia.org/wiki/Ischemiahttps://en.wikipedia.org/wiki/Infectionhttps://en.wikipedia.org/wiki/Ischemic_woundhttps://en.wikipedia.org/wiki/Revascularizationhttps://en.wikipedia.org/wiki/Vascular_bypasshttps://en.wikipedia.org/wiki/Angioplastyhttps://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(medicine)https://en.wikipedia.org/wiki/Wikipedia:Identifying_reliable_sources_(medicine)https://en.wikipedia.org/wiki/Diabetes_mellitushttps://en.wikipedia.org/wiki/Gangrene#cite_note-8https://en.wikipedia.org/wiki/Prognosishttps://en.wikipedia.org/wiki/Sepsishttps://en.wikipedia.org/wiki/Putrefying_bacteriahttps://en.wikipedia.org/wiki/Clostridium_perfringenshttps://en.wikipedia.org/wiki/Bacillus_fusiformishttps://en.wikipedia.org/wiki/Fetidhttps://en.wikipedia.org/wiki/Guillotine_amputationhttps://en.wikipedia.org/wiki/Gangrene#cite_note-CochAmp-9https://en.wikipedia.org/wiki/Below_knee_amputationhttps://en.wikipedia.org/wiki/Above_knee_amputationhttps://en.wikipedia.org/wiki/Gangrene#cite_note-CochAmp-9https://en.wikipedia.org/wiki/Gas_gangrenehttps://en.wikipedia.org/wiki/Clostridiumhttps://en.wikipedia.org/wiki/Clostridium_perfringens_alpha_toxinhttps://en.wikipedia.org/wiki/Clostridium_perfringenshttps://en.wikipedia.org/wiki/Gangrene#cite_note-Yang-6https://en.wikipedia.org/wiki/Gangrene#cite_note-Sakurai-10


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infiltrate healthy tissue in the icinity. Because of its aility to Auickly spread to surrounding

tissues, gas gangrene should e treated as a medical emergency.

'as gangrene is caused y acteriale3oto3inproducing clostridial species, hich are mostlyfound in soil, and other anaeroes such asBacteroidesand anaeroic streptococci. -hese

enironmental acteria may enter the muscle through a ound and suseAuently proliferate innecrotic tissue and secrete poerful to3ins. -hese to3ins destroy neary tissue, generating gas at

the same time. gas composition of %." hydrogen, !.# caron dio3ide, 7#.% nitrogen, and. o3ygen as reported in one clinical case.()

'as gangrene can cause necrosis,gas production, and sepsis. Grogression to to3emiaand shock

is often ery rapid.

&t'er

Hecroti1ing fasciitisis an infection that spreads deep into the ody along tissue planes.

Homais a gangrene of the face.

Fournier gangreneis a type of necroti1ing fasciitis that usually affects the genitals and

groin.(2)

enous lim gangrene may e caused y heparininduced thromocytopenia and

thromosis *6I--+.(!)

8eere mesenteric ischemiamay result in gangrene of thesmall intestine.

8eere ischemic colitismay result in gangrene of the large intestine.

$reat#ent

-he method of treatment is generally determined y the location of affected tissue and e3tent of

tissue loss. -he est treatment for gangrene is reasculari1ation*i.e., restoration of lood flo+

of the afflicted organ, hich can reerse some of the effects of necrosis and allo healing. 5thertreatments include antiiotic therapy, ound care, deridementand surgicalamputation.

Cost amputations are performed for ischemic disease of the loer e3tremity. 5f dysascular

amputations, %J2$ of patients undergo contralateral lim amputations ithin ! years. 5felderly persons ho undergo amputations, %0 surie the first ! years. (#)

In the Knited 8tates, !0,000J#0,000 amputations are performed annually. -here ere an

estimated . million indiiduals liing ith the loss of a lim in 200%L these estimates are

e3pected to more than doule to !. million such indiiduals y the year 20%0.(%)ntiioticsalone are not effectie ecause they may not penetrate infected tissues sufficiently.()6yperaric

o3ygen therapy*6B5-+ treatment is used to treat gas gangrene. 6B5- increases pressure and
https://en.wikipedia.org/wiki/Medical_emergencyhttps://en.wikipedia.org/wiki/Exotoxinhttps://en.wikipedia.org/wiki/Exotoxinhttps://en.wikipedia.org/wiki/Bacteroideshttps://en.wikipedia.org/wiki/Bacteroideshttps://en.wikipedia.org/wiki/Streptococcushttps://en.wikipedia.org/wiki/Gangrene#cite_note-11https://en.wikipedia.org/wiki/Gangrene#cite_note-11https://en.wikipedia.org/wiki/Necrosishttps://en.wikipedia.org/wiki/Necrosishttps://en.wikipedia.org/wiki/Bacteremiahttps://en.wikipedia.org/wiki/Septic_shockhttps://en.wikipedia.org/wiki/Septic_shockhttps://en.wikipedia.org/wiki/Necrotizing_fasciitishttps://en.wikipedia.org/wiki/Noma_(disease)https://en.wikipedia.org/wiki/Fournier_gangrenehttps://en.wikipedia.org/wiki/Fournier_gangrenehttps://en.wikipedia.org/wiki/Gangrene#cite_note-12https://en.wikipedia.org/wiki/Heparin-induced_thrombocytopeniahttps://en.wikipedia.org/wiki/Heparin-induced_thrombocytopeniahttps://en.wikipedia.org/wiki/Gangrene#cite_note-13https://en.wikipedia.org/wiki/Mesenteric_ischemiahttps://en.wikipedia.org/wiki/Mesenteric_ischemiahttps://en.wikipedia.org/wiki/Small_intestinehttps://en.wikipedia.org/wiki/Small_intestinehttps://en.wikipedia.org/wiki/Small_intestinehttps://en.wikipedia.org/wiki/Ischemic_colitishttps://en.wikipedia.org/wiki/Large_intestinehttps://en.wikipedia.org/wiki/Large_intestinehttps://en.wikipedia.org/wiki/Revascularizationhttps://en.wikipedia.org/wiki/Debridementhttps://en.wikipedia.org/wiki/Amputationhttps://en.wikipedia.org/wiki/Amputationhttps://en.wikipedia.org/wiki/Gangrene#cite_note-14https://en.wikipedia.org/wiki/Gangrene#cite_note-15https://en.wikipedia.org/wiki/Gangrene#cite_note-15https://en.wikipedia.org/wiki/Gangrene#cite_note-15https://en.wikipedia.org/wiki/Gangrene#cite_note-16https://en.wikipedia.org/wiki/Gangrene#cite_note-16https://en.wikipedia.org/wiki/Gangrene#cite_note-16https://en.wikipedia.org/wiki/Hyperbaric_medicinehttps://en.wikipedia.org/wiki/Hyperbaric_medicinehttps://en.wikipedia.org/wiki/Hyperbaric_medicinehttps://en.wikipedia.org/wiki/Medical_emergencyhttps://en.wikipedia.org/wiki/Exotoxinhttps://en.wikipedia.org/wiki/Bacteroideshttps://en.wikipedia.org/wiki/Streptococcushttps://en.wikipedia.org/wiki/Gangrene#cite_note-11https://en.wikipedia.org/wiki/Necrosishttps://en.wikipedia.org/wiki/Bacteremiahttps://en.wikipedia.org/wiki/Septic_shockhttps://en.wikipedia.org/wiki/Necrotizing_fasciitishttps://en.wikipedia.org/wiki/Noma_(disease)https://en.wikipedia.org/wiki/Fournier_gangrenehttps://en.wikipedia.org/wiki/Gangrene#cite_note-12https://en.wikipedia.org/wiki/Heparin-induced_thrombocytopeniahttps://en.wikipedia.org/wiki/Heparin-induced_thrombocytopeniahttps://en.wikipedia.org/wiki/Gangrene#cite_note-13https://en.wikipedia.org/wiki/Mesenteric_ischemiahttps://en.wikipedia.org/wiki/Small_intestinehttps://en.wikipedia.org/wiki/Ischemic_colitishttps://en.wikipedia.org/wiki/Large_intestinehttps://en.wikipedia.org/wiki/Revascularizationhttps://en.wikipedia.org/wiki/Debridementhttps://en.wikipedia.org/wiki/Amputationhttps://en.wikipedia.org/wiki/Gangrene#cite_note-14https://en.wikipedia.org/wiki/Gangrene#cite_note-15https://en.wikipedia.org/wiki/Gangrene#cite_note-16https://en.wikipedia.org/wiki/Hyperbaric_medicinehttps://en.wikipedia.org/wiki/Hyperbaric_medicine


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o3ygen content to allo lood to carry more o3ygen to inhiit anaeroic organism groth and

reproduction.(7) regeneratie medicine therapy as deeloped y Dr.Geter DeCarcoto treat

diaetic gangrene to aoid amputations. 'roth factors, hormones and skin grafts hae also eenused to accelerate healing for gangrene and otherchronic ounds.

ngioplastyshould e considered if seere lockage in loer leg essels *tiialandperonealartery+ leads to gangrene.($)

!istory

merican 4iil Warsoldier lies in ed ith a gangrenous amputated arm

s early as 02$ flymaggotsere commonly(citation needed)used to treat chronic ounds or ulcersto

preent or arrest necrotic spread, as some species of maggots consume only dead flesh, leaing

neary liing tissue unaffected. -his practice largely died out after the introduction of antiiotics,acetonitrile(citation needed)anden1ymeto the range of treatments for ounds. In recent times,

hoeer, maggot therapyhas regained some crediility and is sometimes employed ith great

efficacyin cases of chronic tissue necrosis.

Mohn C. -romold rote @Ciddleton 'oldsmith, a surgeon in the Knion rmyduring themerican 4iil War, meticulously studied hospital gangrene and deeloped a reolutionary

treatment regimen. -he cumulatie 4iil War hospital gangrene mortalityas #% percent.

'oldsmithNs method, hich he applied to oer !!0 cases, yielded a mortality under ! percent.@(")'oldsmith adocated the use of deridement and topical and in/ectedromidesolutions on

infected ounds to reduce the incidence and irulence of Opoisoned miasma.P 4opies of his ook

ere issued to Knion surgeons to encourage the use of his methods.(20)

See also

Frank damo, a prison camp physician during World War II ho deeloped a uniAuetreatment for the disease

llan Ginkerton, one of the cofounders of the Ginkerton Detectie gency, ho

succumed to gangrene of the tongue after slipping on the sidealk.

(eferences
https://en.wikipedia.org/wiki/Gangrene#cite_note-17https://en.wikipedia.org/wiki/Peter_DeMarcohttps://en.wikipedia.org/wiki/Peter_DeMarcohttps://en.wikipedia.org/wiki/Chronic_woundshttps://en.wikipedia.org/wiki/Chronic_woundshttps://en.wikipedia.org/wiki/Angioplastyhttps://en.wikipedia.org/wiki/Posterior_tibial_arteryhttps://en.wikipedia.org/wiki/Posterior_tibial_arteryhttps://en.wikipedia.org/wiki/Peroneal_arteryhttps://en.wikipedia.org/wiki/Peroneal_arteryhttps://en.wikipedia.org/wiki/Peroneal_arteryhttps://en.wikipedia.org/wiki/Gangrene#cite_note-18https://en.wikipedia.org/wiki/American_Civil_Warhttps://en.wikipedia.org/wiki/Flyhttps://en.wikipedia.org/wiki/Maggothttps://en.wikipedia.org/wiki/Maggothttps://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttps://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttps://en.wikipedia.org/wiki/Ulcer_(dermatology)https://en.wikipedia.org/wiki/Antibioticshttps://en.wikipedia.org/wiki/Acetonitrilehttps://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttps://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttps://en.wikipedia.org/wiki/Enzymehttps://en.wikipedia.org/wiki/Enzymehttps://en.wikipedia.org/wiki/Maggot_therapyhttps://en.wikipedia.org/wiki/Efficacyhttps://en.wikipedia.org/wiki/Union_Armyhttps://en.wikipedia.org/wiki/Case_fatality_ratehttps://en.wikipedia.org/wiki/Gangrene#cite_note-19https://en.wikipedia.org/wiki/Gangrene#cite_note-19https://en.wikipedia.org/wiki/Bromidehttps://en.wikipedia.org/wiki/Bromidehttps://en.wikipedia.org/wiki/Gangrene#cite_note-20https://en.wikipedia.org/wiki/Frank_Adamohttps://en.wikipedia.org/wiki/Allan_Pinkertonhttps://en.wikipedia.org/wiki/Pinkerton_(detective_agency)https://en.wikipedia.org/wiki/Gangrene#cite_note-17https://en.wikipedia.org/wiki/Peter_DeMarcohttps://en.wikipedia.org/wiki/Chronic_woundshttps://en.wikipedia.org/wiki/Angioplastyhttps://en.wikipedia.org/wiki/Posterior_tibial_arteryhttps://en.wikipedia.org/wiki/Peroneal_arteryhttps://en.wikipedia.org/wiki/Peroneal_arteryhttps://en.wikipedia.org/wiki/Gangrene#cite_note-18https://en.wikipedia.org/wiki/American_Civil_Warhttps://en.wikipedia.org/wiki/Flyhttps://en.wikipedia.org/wiki/Maggothttps://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttps://en.wikipedia.org/wiki/Ulcer_(dermatology)https://en.wikipedia.org/wiki/Antibioticshttps://en.wikipedia.org/wiki/Acetonitrilehttps://en.wikipedia.org/wiki/Wikipedia:Citation_neededhttps://en.wikipedia.org/wiki/Enzymehttps://en.wikipedia.org/wiki/Maggot_therapyhttps://en.wikipedia.org/wiki/Efficacyhttps://en.wikipedia.org/wiki/Union_Armyhttps://en.wikipedia.org/wiki/Case_fatality_ratehttps://en.wikipedia.org/wiki/Gangrene#cite_note-19https://en.wikipedia.org/wiki/Bromidehttps://en.wikipedia.org/wiki/Gangrene#cite_note-20https://en.wikipedia.org/wiki/Frank_Adamohttps://en.wikipedia.org/wiki/Allan_Pinkertonhttps://en.wikipedia.org/wiki/Pinkerton_(detective_agency)


6/6

. Porth, Carol (2007).Essentials of pathophysiology.Lippincott illiams !

il"ins. p. #$.%&B'7*0*7$7*707*+. etrie-ed 20$0*0*$/.

2. 1angrene %ntroduction.'3& 3ealth 45.'3&. etrie-ed 20$0*0*$/.

!. 1angrene Causes.'3& 3ealth 45. 'ational 3ealth &er-ice (England).etrie-ed 20$0*0*$/.

#. 1angrene 6reatment. '3& 3ealth 45. 'ational 3ealth &er-ice (England).

etrie-ed 20$0*0*$/.

%. 1ardner, 4 4fa8, 4 ('o-em9er:ecem9er 200). ;anagement of loournal of cardiopulmonary reha9ilitation and

pre-ention 28()? +#+/7. [email protected]$+e+$$c+9.P;C27#+#.

P;%:$00.

. Aang, 5. 3u, >. u, A. &un, . Leng, D. Li, 3. 5han, &. (20$+). %nter-entionsfor treating gas gangrene (Protocol). Cochrane :ata9ase of &ystematic e-ie. 'agahama, ;. Ida, ;. ('o-em9er 200#). Clostridium perfringens

alpha*to=in? characteriFation and mode of action. >ournal of Biochemistry 136(/)?

//7#. doi?$0.$0+@H9@m-h$$.P;%:$/+22/.
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