Wet gangrene

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 or venous disease, but can also be sequelae of trauma or burns causing vascular injuries.
  • Presents with swollen, pale, soft tissue, often with a putrid smell and purulent discharge.
  • As tissue is infected, wet gangrene presents a higher risk of systemic infection than dry gangrene.

Differential Diagnosis

Foot infection

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Evaluation

Workup

Diagnosis

  • History and physical examination are usually sufficient to make the diagnosis.
  • Given higher risk for systemic infection, patients should be evaluated for signs/symptoms of sepsis

Management

  • Wet gangrene requires broad spectrum antibiotic coverage, as these are often polymycrobial infections.
  • Requires surgical consultation as rapid debridement or amputation of necrotic tissue is required to prevent further spread of infection.

Disposition

  • Admission

See Also

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References