Macroscopic death of tissue with putrefaction. Pre gangrene: rest pain, colour changes, oedema, hyperaesthesia, ischaemic ulceration Types: dry and wet

1. GANGRENE

2. GANGRENE
• Macroscopic death of tissue with putrefaction.
• Pre gangrene: rest pain, colour changes, oedema, hyperaesthesia,
ischaemic ulceration
• Types: dry and wet

3. DRY GANGRENE
• Blood supply; arterial - gradually deprived
• venous flow - unimpeded
• Arterial occlusion- chronic or acute
• Colour change: Greenish- black - dry-mummfied.
• Line of seperation is present.
• Stump is conical.

4. DRY GANGRENE
• Line of demarcation: dead tissue and living tissue.
• Band of Hyperemia
• layer of granulation
• Hyperesthesia seen in: Senile, diabetic, burger's , raynaud's, frost bite,
vascular occlusion, embolism, ligation

6. WET GANGRENE
• Arterial & venous block
• Infection and putrefaction.
• Cold , pulseless, swollen, oedematous, blebs
• Horrible odour
• No line of demarcation
• Constitutional symptoms present.
• Spreads faster
• Seen in: acute inflammation, venous thrombosis,
• Gas gangrene, bed sores

7. • ARTERIAL OCCLUSION: atherosclerosis, embolism, raynaud's, buerger's,
cervical rib, syphilitic
• VENOUS OBSTRUCTION: DVT
• NERVOUS DISEASE: peripheral neuritis, tabes dorsalis, syringomyelia,
leprosy, hemiplegia
• TRAUMATIC : Direct or indirect
• INFECTIVE: carbuncle, gas gangrene, fourniers gangrene

8. • DIABETIC GANGRENE
• PHYSICAL: Heat- burns and scalds.
• Cold - frost bite
• corrosive - alkalis, acids
• electricity
• Irridiation

11. GAS GANGRENE
• Clostridium
• Trauma and ischemia
• Exotoxins produced
• Necrosis with gas production - rapidly
• Clinical features: pain, fever, swelling, Toxaemia, foul smelling khaki
brown skin, Crepitus
• Types : fulminant , massive, group, subcutaneous, single

13. DIABETIC GANGRENE
• Atherosclerosis
• Peripheral neuritis
• Infection - hyperglycaemia
• Wet gangrene - young
• Dry gangrene- old, atherosclerotic