Dry gangrene

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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

Dry Gangrene.png
  • 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

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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, so management involves keeping the area clean and dry to prevent infection. Will usually auto-amputate in <6 months. Should be referred to vascular surgery as auto-amputation may not occur, and they may benefit from revascularization therapies to prevent further tissue death.
  • If acute limb ischemia is present, embolectomy or surgical bypass may be required to restore flow.

Disposition

See Also

External Links

References