Gangrene and amputation

m

1. GANGRENE Logman Mohammed

2. Outlines Introduction Types of gangrene Risk factors S/ S Investigation Treatment

3. Introduction Gangrene is the medical term for the death of soft tissue as a result of the loss of blood supply to the affected part of the body

4. Introduction The loss of blood supply result from : A disorder of the circulatory system ( Ischemia ) Atheroma in major blood vessel Frostbite ( damage of tissue by freezing ) Sever burn DM T rauma , I nfection . with bacteria called Clostridium that produce toxin. Introduction

5. Gangrene most commonly involves the : fingers, toes , hands , or feet , but can also develop within the internal organs. Introduction

6. T wo major types

7. Dry gangrene is caused by a gradual loss of blood flow through the arteries. develops slowly over a period of years as the person’s circulation is impaired by : A therosclerosis D iabetes , long-term smoking .

8. begins at the distal part of the limb due to ischemia . occurs in the toes and feet infection is typically not present mainly due to arterial occlusion . The affected part is dry , shrunken dark reddish-black cold and numb fall off Dry gangrene can lead to wet gangrene if it becomes infected.  Dry gangrene

9. Dry gangrene Dry gangrene

10. It is caused by an untreated wound infection or by bacteria growing in tissue Bedsores are a type of wet gangrene Gas gangrene is a deadly subtype of wet gangrene caused by bacteria known as Clostridium perfringens grows in the absence of oxygen. It produces gas as well as toxins ; these compounds expand and spread rapidly through nearby tissues . Gas gangrene is a medical emergency

11. develops when the blood flow to the affected body part is blocked —often by a traumatic injury T he blood that collects in the soft tissues supports the rapid growth of bacteria , W hich causes the tissues to swell and produce a foul-smelling discharge Wet gangrene

12. The affected area is usually: D iscolored V ery painful, T he patient typically develops a fever. If the gangrene is not treated, the bacterial infection can spread throughout the body via the bloodstream and kill the patient, has a poor prognosis due to septicemia . Wet gangrene

13. Usually develops rapidly due to blockage of venous (mainly) or arterial blood flow. It is called "wet" because of pus. Wet gangrene

14. Wet gangrene

15. I s a type of wet gangrene caused by Clostridium perfringens S welling and pain in the affected area, T he tissue may also crackle or make a popping sound if presses on the affected area. The patient will become very sick very quickly with gas gangrene: shock , sweating heavily, developing mental symptoms (confusion and disorientation).

16. It is a deadly form of gangrene Infection spreads rapidly as the gases produced by bacteria expand and infiltrate healthy tissue. Because of its ability to quickly spread to surrounding tissues, gas gangrene can causes septicemia which is emergency condition . Gas gangrene

17. Gas gangrene

18. Risk factors for gangrene Old age. develop circulatory disorders be confined to bed and develop bedsores . Diabetes (weaken the blood vessels over time) Diseases of the blood vessels. HIV infection. Radiation or chemotherapy for cancer. Severe injury, including frostbite. Long-term smoking. The chemicals in tobacco smoke cause the blood vessels to narrow, reducing the supply of oxygen to body tissues

19. S igns and Symptoms Severe pain numbness A foul-smelling discharge Skin changes (discoloration , warmth, swelling , blisters or lesions). Low blood pressure temperature greater than (38 C) or lower than (36 C) Rapid heart rate & Shortness of breath Confusion

20. Investigation Blood Tests ( WBCs , bacteria ) Wound culture ( Tissue or Fluid Samples) X-rays , look for gas bubbles MRI scans, or CT scans . for the spread of gangrene Arteriogram to determine whether the patient’s arteries are blocked

21. Treatment Surgical debridement Antibiotic therapy, Skin grafts Hyperbaric oxygen therapy (HBOT) treatment is used to treat gas gangrene . Angioplasty bypass surgery if severe blockage in lower leg vessels Amputation

22. Nursing Care Plan Prevention cleansing wounds promptly with an antiseptic; watching for signs of infection in the wound (pus, redness, swelling, and unusual pain); going to the doctor at once if a wound looks infected. People with diabetes need to take special care to prevent gangrene in the feet . diabetes affects the nerves in the feet, causing a loss of sensation. The diabetic person may not notice a cut or other injury to the foot because they cannot feel it. An infection can then develop and lead to gangrene.

23. people with diabetes take the following precautions to prevent gangrene in their feet : Wash the feet in warm (not hot) water every day and dry them completely, particularly between the toes. Check the feet every day for cuts, blisters, swelling, redness, calluses, or toenail problems. Cut the toenails once a week after washing the feet. Always wear shoes or slippers to protect the feet from injuries. Always wear socks or stockings to prevent blisters, even when wearing sandals. Wear shoes that fit well, and check them before wearing to make sure there are no rough edges that might injure the feet. Nursing Care Plan Prevention

24. Thanks