Dry gangrene: Difference between revisions
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==Management== | ==Management== | ||
*Infection rarely present | *Infection rarely present | ||
**<8% of cases convert to wet gangrene <ref> Latz CA et.al. Rates of conversion from dry to wet gangrene following lower extremity revascularization. Ann Vasc Surg. 2022;83:20–25. https://www.sciencedirect.com/science/article/pii/S0890509622000115. doi: 10.1016/j.avsg.2022.01.005. </ref> | |||
*Keep area clean and dry to prevent infection; consider debridement | *Keep area clean and dry to prevent infection; consider debridement | ||
*Will usually auto-amputate in <6mo | *Will usually auto-amputate in <6mo | ||
*Refer to vascular surgery in case fails to auto-amputate; may benefit from revascularization therapy to prevent further tissue death. Diabetes or immunocompromise may warrant lower threshold for consultation <ref> Rodrigues J, Mitt N. Diabetic Foot and Gangrene. Gangrene - Current Concepts and Management Options. Published online August 29, 2011. doi:https://doi.org/10.5772/23994 </ref> | *Refer to vascular surgery in case fails to auto-amputate; may benefit from revascularization therapy to prevent further tissue death. | ||
**Diabetes or immunocompromise may warrant lower threshold for consultation <ref> Rodrigues J, Mitt N. Diabetic Foot and Gangrene. Gangrene - Current Concepts and Management Options. Published online August 29, 2011. doi:https://doi.org/10.5772/23994 </ref> | |||
*If [[acute limb ischemia]] is present, embolectomy or surgical bypass may be required to restore flow. | *If [[acute limb ischemia]] is present, embolectomy or surgical bypass may be required to restore flow. | ||
Revision as of 18:26, 21 May 2025
Background
Gangrene General Info
- A form of tissue necrosis characterized by critically insufficient blood supply leading to tissue death.
- Primarily divided into wet gangrene vs dry gangrene. Other, specific forms of gangrene include Fournier's gangrene, gas gangrene, and necrotizing fasciitis.
- Most commonly occur in distal extremities, clasically the feet.
- Main risk factors are diabetes, smoking, and peripheral arterial disease.
Clinical Features
- Usually due to peripheral arterial disease, but can also be caused by acute limb ischemia.
- Presents with dry, shrunken tissue, usually ranging from dark red to completely black, often with a clear line of demarcation between healthy and necrotic tissue.
- Typically not painful.
Differential Diagnosis
Foot infection
- Gout
- PsuedoGout
- Cellulitis
- Gangrene
- Trench foot
- Abscess
- Necrotizing soft tissue infections
- Osteomyelitis
- Diabetic foot infection
- Charcot Foot
Look A-Likes
Evaluation
- History and physical examination are usually sufficient to make the diagnosis.
- If acute limb ischemia is suspected, consider a CTA of the affected limb and a vascular surgery consultation.
Management
- Infection rarely present
- <8% of cases convert to wet gangrene [1]
- Keep area clean and dry to prevent infection; consider debridement
- Will usually auto-amputate in <6mo
- Refer to vascular surgery in case fails to auto-amputate; may benefit from revascularization therapy to prevent further tissue death.
- Diabetes or immunocompromise may warrant lower threshold for consultation [2]
- If acute limb ischemia is present, embolectomy or surgical bypass may be required to restore flow.
Disposition
- Outpatient, if acute limb ischemia is NOT a concern
See Also
External Links
References
- ↑ Latz CA et.al. Rates of conversion from dry to wet gangrene following lower extremity revascularization. Ann Vasc Surg. 2022;83:20–25. https://www.sciencedirect.com/science/article/pii/S0890509622000115. doi: 10.1016/j.avsg.2022.01.005.
- ↑ Rodrigues J, Mitt N. Diabetic Foot and Gangrene. Gangrene - Current Concepts and Management Options. Published online August 29, 2011. doi:https://doi.org/10.5772/23994