GangreneR02.x0

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Brand; Gangraena; Skin gangrene

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DefinitionThis section has been translated automatically.

Dehydration or bacterial decomposition of necrotic tissue.

EtiopathogenesisThis section has been translated automatically.

Occurrence at acra of the extremities in case of arterial embolism or microangiopathy (e.g. diabetes mellitus).

Clinical featuresThis section has been translated automatically.

Dry gangrene: mummification, drying and shrinking of the necrotic tissue, resulting in a leathery, black appearance; wet gangrene: decomposition of the necrotic tissue by putrefactive bacteria: transformation into a stinking, putrid, melting mass.

General therapyThis section has been translated automatically.

Treatment of the underlying disease, cooperation with angiologists and vascular surgeons. Elimination of risk factors (e.g. nicotine).

External therapyThis section has been translated automatically.

  • Dry gangrene: Basically dry treatment to avoid climate for microbial colonization. Antimicrobial treatment by dabbing with polihexanide (Serasept, Prontoderm), polyvidon iodine solution(e.g. Betaisodona solution) or dye solutions, allow to dry and then connect dry. If necessary, protect the environment with hard zinc paste ( R295 ). See also Wound treatment.
  • Moist gangrene: The aim of the treatment is to dry off, remove microbial colonisation and prevent or limit progression. Remove moist necroses, if necessary clean the wound bed with degrading enzymes (e.g. Leukase N ointment). Dab with Polihexanid Lsg. (Lavasept), polyvidon-iodine solution (e.g. Betaisodona, R203 ) or dye solutions; then allow to dry and dress dry. If necessary, blow dry. See also Wound treatment.

Internal therapyThis section has been translated automatically.

In case of inflammatory environmental reaction internal antibiotics with broad-spectrum antibiotics such as cefuroxime (e.g. Zinacef) 4 times 1 g/day i.v. Therapy after antibiogram as soon as possible.

Operative therapieThis section has been translated automatically.

Keep deep fistulas open, address any osteomyelitis present surgically. The final measure is amputation.

ProphylaxisThis section has been translated automatically.

No constricting shoes, soft positioning, relief and immobilization of the affected extremities, careful foot care!

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Last updated on: 29.10.2020