Dry gangrene: Difference between revisions
No edit summary |
ClaireLewis (talk | contribs) |
||
Line 16: | Line 16: | ||
==Management== | ==Management== | ||
* Infection rarely present | *Infection rarely present | ||
* If acute limb ischemia is present, embolectomy or surgical bypass may be required to restore flow. | *Keep area clean and dry to prevent infection | ||
*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 | |||
*If [[acute limb ischemia]] is present, embolectomy or surgical bypass may be required to restore flow. | |||
==Disposition== | ==Disposition== |
Revision as of 20:21, 17 September 2019
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
- Cellulitis
- Gangrene
- Trench foot
- Abscess
- Necrotizing soft tissue infections
- Osteomyelitis
- Diabetic foot infection
- Wet-sock erosions
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
- Keep area clean and dry to prevent infection
- 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
- 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