Gangrene - China Slitting Machine - China Slitting Line
Etymology
Etymology
The etymology of gangrene derives from the Latin word "gangraena" and from the Greek gangraina (), which means "putrefaction of tissues". It has no etymological connection with the word green, despite the affected area turning black and/or green. Coincidentally, in Lowland Scots the words "gang green" (going green) can be said to be an eggcorn for gangrene as it describes the symptoms of the affliction.
Types of gangrene
Dry gangrene
Diabetic ulceration with central "dry" gangrene and toward the edges wet gangrene with some ascending cellulitis
Dry gangrene begins at the distal part of the limb due to ischemia and often occurs in the toes and feet of elderly patients due to arteriosclerosis. Dry gangrene spreads slowly until it reaches the point where the blood supply is inadequate to keep tissue viable. Macroscopically, the affected part is dry, shrunken and dark black, resembling mummified flesh. The dark coloration is due to liberation of hemoglobin from hemolyzed red blood cells which is acted upon by hydrogen sulfide (H2S) produced by the bacteria, resulting in formation of black iron sulfide that remains in the tissues. The line of separation usually brings about complete separation with eventual falling off of the gangrenous tissue if it is not removed surgically.
If the blood flow is interrupted for a reason other than severe bacterial infection, the result is a case of dry gangrene. People with impaired peripheral blood flow, such as diabetics, are at greater risk of contracting dry gangrene.
The early signs of dry gangrene are a dull ache and sensation of coldness in the affected area along with pallor of the flesh. If caught early, the process can sometimes be reversed by vascular surgery. However, if necrosis sets in, the affected tissue must be removed just as with wet gangrene.
Dry Gangrene with dead toes and visible bone of 85 years old female (left leg).
Wet gangrene
Severe Infection - Wet gangrene in center
Wet gangrene occurs in naturally moist tissue and organs such as the mouth, bowel, lungs, cervix, and vulva. Bedsores occurring on body parts such as the sacrum, buttocks and heelslthough not necessarily moist areasre also categorized as wet gangrene infections. In wet gangrene, the tissue is infected by saprogenic microorganisms (Bac.perfringes, fusiformis, putrificans, etc.), which cause tissue to swell and emit a fetid smell. Wet gangrene usually develops rapidly due to blockage of venous and/or arterial blood flow. The affected part is saturated with stagnant blood which promotes the rapid growth of bacteria. The toxic products formed by bacteria are absorbed causing systemic manifestation of septicemia and finally death. Macroscopically, the affected part is edematous, soft, putrid, rotten and dark. The darkness in wet gangrene occurs due to the same mechanism as in dry gangrene.
Gas gangrene
Main article: Gas gangrene
Gas gangrene is a bacterial infection that produces gas within tissues. It is a deadly form of gangrene usually caused by Clostridium perfringens bacteria. Infection spreads rapidly as the gases produced by bacteria expand and infiltrate healthy tissue in the vicinity. Because of its ability to quickly spread to surrounding tissues, gas gangrene should be treated as a medical emergency.
Gas gangrene is caused by a bacterial exotoxin-producing clostridial species, which are mostly found in soil and other anaerobes (e.g. Bacteroides and anaerobic streptococci). These environmental bacteria may enter the muscle through a wound and subsequently proliferate in necrotic tissue and secrete powerful toxins. These toxins destroy nearby tissue, generating gas at the same time. A gas composition of 5.9% hydrogen, 3.4% carbon dioxide, 74.5% nitrogen and 16.1% oxygen was reported in one clinical case.
Gas gangrene can cause necrosis, gas production, and sepsis. Progression to toxemia and shock is often very rapid.
Specific gangrenes
Noma is a gangrene of the face.
Necrotizing fasciitis affects the deeper layers of the skin.
Fournier gangrene usually affects the male genitals.
Treatment
As early as 1028, when antibiotics had not yet been discovered, fly maggots were commonly[citation needed] used to treat chronic wounds or ulcers to prevent or arrest necrotic spread, as some species of maggots consume only dead flesh, leaving nearby living tissue unaffected. This practice largely died out after the introduction of antibiotics, acetonitrile[citation needed] and enzyme to the range of treatments for wounds. Recently, however, maggot therapy has regained some credibility and is sometimes employed with great efficacy in cases of chronic tissue necrosis.
In modern times treatment is usually surgical debridement, and excision with amputation is necessary in many cases. Antibiotics alone are not effective because they do not penetrate ischemic muscles sufficiently.
See also
Tetanus
Wound healing
Liquefactive necrosis
Bedsore
References
^ Clostridium as cause for gangrene
^ chapter 3.html
^ Chi CH, Chen KW, Huang JJ, Chuang YC, Wu MH (December 1995). "Gas composition in Clostridium septicum gas gangrene". J. Formos. Med. Assoc. 94 (12): 7579. PMID 8541740.
vde
Symptoms and signs: respiratory system (R04-R07, 786)
Hemorrhage
Epistaxis Hemoptysis
Abnormalities
of breathing
Respiratory sounds: Stridor Wheeze Rales Rhonchi Hamman's sign
Dyspnea Hyperventilation/Hypoventilation Hyperpnea/Tachypnea/Bradypnea Orthopnea/Platypnea
Biot's respiration Cheyne-Stokes respiration Kussmaul breathing
Hiccup Mouth breathing/Snoring Breath-holding
Other
Asphyxia Cough Pleurisy Sputum
Respiratory arrest Hypercapnia/Hypocapnia
Pectoriloquy: Whispered pectoriloquy Egophony Bronchophony
Pleural friction rub
Fremitus
Chest, general
Chest pain
respiratory system navs: anat nose, larynx/lower+thoracic cavity/physio/dev, noncongen/congen/tumors, symptoms+signs/eponymous, proc
Categories: Diseases and disordersHidden categories: Articles needing additional references from February 2008 | All articles needing additional references | All articles with unsourced statements | Articles with unsourced statements from April 2008 | Articles with unsourced statements from February 2009
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