GANGRENE ................................

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1. gas gangrene by dr m akanksha 1st year post graduate government general hospital siddipet

2. GANGRENE Gangrene refers to death(necrosis) of tissues with or without superadded putrefaction Gas forming organisms form gas gangrene black discolouration due to breakdown of hemoglobin and formation of iron sulphide

3. TYPES OF GANGRENE DRY GANGRNE WET GANGRENE GAS GANGRENE

4. DRY GANGRENE IT IS CAUSED BY REDUCTION OF BLOOD FLOW THROUGH THE ARTERIES IN THIS TYPE, THE TISSUES BECOME COLD AND BLACK BEGINS TO DRY AND EVENTUALLY SLOUGHS OFF SEEN IN PEOPLE WITH DIABETES,INCREASED CHOLESTEROL LEVELS,SMOKING

5. THE GANGRENE SPREADS SLOWLY UPWARDS UNTIL IT REACHES A POINT WHERE THE BLOOD SUPPLY IS ADEQUATE TO KEEP THE TISSUE VIABLE MORPHOLOGICAL FEATURES - GROSSLY THE AFFECTED PART IS DRY SHRUKEN, DARK BLACK HISTOLOGICALLY - THERE IS NECROSIS,LINE OF SEPARATION CONSISTS OF INFLAMMATORY GRANULATION TISSUE

6. WET GANGRENE WET GANGRENE USUALLY DEVELOPS RAPIDLY DUE TO BLOCKAGE OF VENOUS SYSTEM AND LESS COMMONLY ARTERIAL THE AFFECTED PART IS STUFFED WITH BLOOD WHICH FAVOURS THE RAPID GROWTH OF PUTREFACTIVE BACTERIA THE TOXIC PRODUCTS ARE ABSORBED CAUSING PROFOUND SEPTICEMIA AND DEATH THE SPREADING GANGRENE LACKS CLEAR CUT LINE OF DEMARCATION

7. MORPHOLOGICAL FEATURES - GROSSLY ,THE AFFECTED PART Is soft,swollen , putrid and dark For example - gangrene of the bowel , commonly due to strangulated hernia ,volvulus or intussusception Histologically there is coagulative necrosis, line of demarcation between gangrenous and viable segment is not clear

8. Gas gangrene It is a form of wet gangrene caused by gas forming clostridia which gain entry into the tissues through open contaminated wounds,especially in the muscles or as a complication of operation on colon Patients who are immunocompromisd ,diabetic are at greater risk, particularly if they have wounds containing necrotic or foreign material

9. Here the wound infections are associated with severe local Pain, crepitus The wound produces a thin, brown, sweet smelling exudate Edema and spreading gangrene follow the release of collagenase, hyaluronidase,proteases and alpha toxins Grossly, the affected area swollen, oedamatous , painful and cfrepitant due to accumulation of gas bubbles within the tissues

10. Grossly, the affected area sq