Gangrene is the death of body tissue due to reduced blood flow or infection. There are three main types: dry gangrene caused by blocked arteries, wet gangrene which affects moist tissues from blocked veins, and gas gangrene caused by Clostridium bacteria. Signs include black, shrunken tissue in dry gangrene; soft, swollen tissue in wet gangrene; and blisters with foul smell in gas gangrene. Treatment involves antibiotics, supportive care like IV fluids, and potentially amputation or angioplasty depending on the severity and type of gangrene.

1. PATHOLOGY
GANGRENE

2. ◦LEARNING OBJECTIVES
1. Introduction
2. Definition
3. Types
4. Causes
5. Sign and symptoms
6. Management

3. ◦INTRODUCTION
. Gangrene is also called as Edematous myonecrosis
It is the death of tissue caused by lack of blood Flow or necrosis
. The basic type of necrosis in GANGRENE is coagulative necrosis due to ischemia onto which
bacterial infection is superimposed
. Ischemia-it is the lack of blood supply to body part
◦ Definition- Gangrene is nothing but the death of tissue caused by infection or lack of blood
supply to body part.

4. ◦TYPES
1. Dry Gangrene
2. Wet Gangrene
3. Gas Gangrene
1. Dry Gangrene – it is usually seen in the distal part of limbs due to ischemia
. E.g - Dry gangrene in the toes and feet of old patient due to arteriosclerosis.

5. ◦ Causes
1. Arteriosclerosis
2. Buerger’s disease
3. Raynaud’s disease
4. Trauma
5. Ergot poisoning

6. ◦ One the most important thing in dry gangrene is the affected part falls continuously there is no
need to remove it and no any surgery require
◦ Affected part in dry gangrene is dark black because liberation of hemoglobin which react with
hydrogen disulfide produced by bacteria resulting in formation of black iron sulfied.
◦ Sign and symptoms
1. Affected part is dry
2. Shrunken
3. Dark black

7. ◦ Wet Gangrene- wet gangrene usually occur in naturally moist tissue and organs such as mouth , bowel
,lungs ,cervix and vulva ect.
◦ Causes
1. Venous blood flow obstruction
2. Less due to atrial blood flow blockage
◦ Sign and symptoms
1. affected part is soft
2. Swollen
3. Putrid
4. Rotten
5. dark

8. 1. Example- Gangrene of bowel commonly due to strangulated hernia,
Volvulus or intussusceptions
2.Example - Diabetic foot
3.example-Bedsores
3.Gas Gangrene – it is arises when considerable mass of body tissue dies.
◦ Causes - Clostridium prefringens
◦ It is gram positive anaerobic gas forming baccilli
◦ It is also called Clostridium myonecrosis

9. ◦ It is usually occur in skeletal muscle and colon
◦Sign and symptoms
1. Grossly affected organ swollen
2. Edematous
3. Crepitus
4. Blisters with foul smelling discharges
5. Microscopically, bacterial colonies seen

10. ◦ Diagnostic evaluation
1.X-ray of blood vessels after injection of
dye Ateriogram
2.Blood test to rule out infection
3.CT- scan and MRI
4.Culture
5.Biopsy
6.Surgery

11. ◦ MANAGEMENT
◦ Pharmacological therapy
1. Penicillin Antibiotic
◦ Other broad spectrum antibiotics
1. Ampicillin plus sulbactum
2. Piperacillin plus tazobactum
◦ SUPPORTIVE CARE
1. i.v fluid
2. Anticoagulant
3. High protein diet
4. Oxygen therapy if needed
◦ SUGICAL MANAGEMENT
◦ Amputation
◦ Angioplasty

12. Thank you!!