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VIII.58 - Gangrene

from Part VIII - Major Human Diseases Past and Present

Published online by Cambridge University Press:  28 March 2008

Kenneth F. Kiple
Affiliation:
Bowling Green State University, Ohio
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Summary

Gangrene is the term used by the clinician to describe local death of tissue (necrosis) occurring in the living body. Gangrene implies a fairly rapid process (developing in days) extending over a large visible area (a few to many centimeters) with an obvious inability of the tissues to repair or replace the gangrenous part. Although gangrene can occur in internal organs (e.g., large intestine), it generally refers to a process occurring on the surface of the body. It may involve only the skin, or it may extend into deeper tissues such as muscle or nerves.

Gangrene may be either dry or moist. Dry gangrene describes necrosis of the tissues of the extremities resulting from vascular occlusion, such as occurs in severe arteriosclerosis of the legs. Wet or moist gangrene occurs when bacteria invades dead tissue, producing putrefaction. When the gas-forming group of bacteria is involved, gas gangrene occurs. A gangrene may be dry at first, and be converted to the moist type by invading bacteria.

Clinical Manifestations

In dry gangrene, the arterial supply is gradually cut off and a drying or mummification of the tissues results. There is frequently an absence of inflammation, but pain of varying degree may precede the color changes. The soft tissue slowly and progressively shrinks and the color gradually deepens until the whole area is coal black. Constitutional symptoms may occur but are less severe than in moist gangrene.

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Publisher: Cambridge University Press
Print publication year: 1993

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References

Brooks, Stewart. 1966. Civil war medicine. Springfield, Ill..Google Scholar
Buck, Albert, ed. 1902. A reference handbook of the medical sciences, Vol. IV, 300–8. New York.Google Scholar
Buerger, Leo. 1924. The circulatory disturbances of the extremities. Philadelphia.Google Scholar
Buerger, Leo. 1983. Thrombo-angiitis: A study of the vascular lesions leading to presenile spontaneous gangrene. American Journal of Medical Sciences 266:. [Reprint of Buerger’s 1908 article in same journal].Google Scholar
Enjalbert, Lise. 1978. De la pourriture d’hôpital à l’infection nosocomiale. Mémoires de l’Académie des Sciences (Toulouse) 140.Google Scholar
Moschella, Samuel L. 1969. The clinical significance of necrosis of the skin. Medical Clinic of North America 53.Google Scholar
Tanner, J. R. 1987. St. Anthony’s fire, then and now: A case report and historical review. Canadian Journal of Surgery 30.Google ScholarPubMed
,U.S. Army. 1884. Index catalogue of the Library of the Surgeon-General’s Office. 1263–80.

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