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1. GANGRENE
Logman Mohammed

2. Outlines
1. Introduction
2. Types of gangrene
3. Risk factors
4. S/ S
5. Investigation
6. Treatment

3. Introduction
Gangrene is the
medical term for the
death of soft tissue as
a result of the loss of
blood supply to the
affected part of the
body

4. Introduction
The loss of blood supply result from :
 A disorder of the circulatory system (Ischemia )
1. Atheroma in major blood vessel
2. Frostbite ( damage of tissue by freezing )
3. Sever burn
4. DM
 Trauma,
 Infection. with bacteria called Clostridium that
produce toxin.
Introduction

5. Gangrene most
commonly involves the :
1. fingers,
2. toes,
3. hands,
4. or feet,
but can also develop
within the internal
organs.
Introduction

6. Two major types
1. Dry
gangrene
2. Wet
gangrene
3. Gas
gangrene

7. Dry gangrene
Dry gangrene is caused by a gradual loss of
blood flow through the arteries.
develops slowly over a period of years as the
person’s circulation is impaired by :
1. Atherosclerosis
2. Diabetes,
3. long-term smoking.

8. begins at the distal part of the limb due to ischemia.
occurs in the toes and feet
infection is typically not present
mainly due to arterial occlusion.
The affected part is
1. dry,
2. shrunken
3. dark reddish-black
4. cold and numb
5. fall off
 Dry gangrene can lead to wet gangrene if it becomes infected.
Dry gangrene

9. Dry gangreneDry gangrene

10. It is caused by an untreated wound infection or
by bacteria growing in tissue
Bedsores are a type of wet gangrene
Gas gangrene is a deadly subtype of wet gangrene
caused by bacteria known as Clostridium perfringens
grows in the absence of oxygen.
It produces gas as well as toxins; these compounds
expand and spread rapidly through nearby tissues.
 Gas gangrene is a medical emergency

11. develops when the blood flow to the affected
body part is blocked—often by a traumatic
injury
The blood that collects in the soft tissues
supports the rapid growth of bacteria,
Which causes the tissues to swell and produce
a foul-smelling discharge

12. The affected area is usually:
 Discolored
 Very painful,
 The patient typically develops a fever.
If the gangrene is not treated, the bacterial
infection can spread throughout the body via
the bloodstream and kill the patient, has a poor
prognosis due to septicemia.

13. Usually develops rapidly due to blockage of
venous (mainly) or arterial blood flow.
It is called "wet" because of pus.

14. Wet gangrene

15. Gas gangrene
 Is a type of wet gangrene caused by Clostridium
perfringens
 Swelling and pain in the affected area,
 The tissue may also crackle or make a popping sound
if presses on the affected area.
The patient will become very sick very quickly with gas
gangrene:
1. shock,
2. sweating heavily,
3. developing mental symptoms (confusion and
disorientation).

16.  It is a deadly form of gangrene
 Infection spreads rapidly as the gases produced
by bacteria expand and infiltrate healthy tissue.
 Because of its ability to quickly spread to
surrounding tissues, gas gangrene can causes
septicemia which is emergency condition .
Gas gangrene

17. Gas gangrene

18. Risk factors for gangrene
 Old age.
develop circulatory disorders
be confined to bed and develop bedsores.
 Diabetes (weaken the blood vessels over time)
 Diseases of the blood vessels.
 HIV infection.
 Radiation or chemotherapy for cancer.
 Severe injury, including frostbite.
 Long-term smoking.
The chemicals in tobacco smoke cause the blood vessels to
narrow, reducing the supply of oxygen to body tissues

19. Signs and Symptoms
1. Severe pain
2. numbness
3. A foul-smelling discharge
4. Skin changes (discoloration, warmth, swelling ,
blisters or lesions).
5. Low blood pressure
6. temperature greater than (38 C) or lower than
(36 C)
7. Rapid heart rate & Shortness of breath
8. Confusion

20. Investigation
1. Blood Tests ( WBCs , bacteria )
2. Wound culture (Tissue or Fluid Samples)
3. X-rays, look for gas bubbles
4. MRI scans, or CT scans. for the spread of
gangrene
5. Arteriogram to determine whether the
patient’s arteries are blocked

21. Treatment
 Surgical debridement
 Antibiotic therapy,
 Skin grafts
 Hyperbaric oxygen therapy (HBOT) treatment
is used to treat gas gangrene.
 Angioplasty bypass surgery if severe blockage
in lower leg vessels
 Amputation

22. Nursing Care Plan Prevention
 cleansing wounds promptly with an antiseptic;
 watching for signs of infection in the wound (pus,
redness, swelling, and unusual pain);
 going to the doctor at once if a wound looks infected.
 People with diabetes need to take special care to
prevent gangrene in the feet .
 diabetes affects the nerves in the feet, causing a loss
of sensation.
 The diabetic person may not notice a cut or other
injury to the foot because they cannot feel it. An
infection can then develop and lead to gangrene.

23. people with diabetes take the following precautions to prevent
gangrene in their feet:
 Wash the feet in warm (not hot) water every day and dry them
completely, particularly between the toes.
 Check the feet every day for cuts, blisters, swelling, redness,
calluses, or toenail problems.
 Cut the toenails once a week after washing the feet.
 Always wear shoes or slippers to protect the feet from injuries.
 Always wear socks or stockings to prevent blisters, even when
wearing sandals.
 Wear shoes that fit well, and check them before wearing to
make sure there are no rough edges that might injure the feet.
Nursing Care Plan Prevention

24. Thanks