Gangrene pathophysiology: Difference between revisions
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In wet gangrene, the tissue is infected by saprogenic microorganisms (Bac.perfringes, fusiformis, putrificans, etc.), which cause tissue to swell and emit a fetid smell. Wet gangrene usually develops rapidly due to blockage of venous and/or arterial blood flow. The affected part is saturated with stagnant blood which promotes the rapid growth of bacteria. The toxic products formed by bacteria are absorbed causing systemic manifestation of [[septicemia]] and finally death. | In wet gangrene, the tissue is infected by saprogenic microorganisms (Bac.perfringes, fusiformis, putrificans, etc.), which cause tissue to swell and emit a fetid smell. Wet gangrene usually develops rapidly due to blockage of venous and/or arterial blood flow. The affected part is saturated with stagnant blood which promotes the rapid growth of bacteria. The toxic products formed by bacteria are absorbed causing systemic manifestation of [[septicemia]] and finally death. | ||
== | ==Gas Gangrene== | ||
Gas gangrene is caused by a bacterial [[exotoxin]]-producing clostridial species, which are mostly found in soil and other anaerobes (e.g. ''[[Bacteroides]]'' and anaerobic [[Streptococcus|streptococci]]). These environmental bacteria may enter the muscle through a wound and subsequently proliferate in necrotic tissue and secrete powerful toxins. These toxins destroy nearby tissue, generating gas at the same time. A gas composition of 5.9% hydrogen, 3.4% carbon dioxide, 74.5% nitrogen and 16.1% oxygen was reported in one clinical case.<ref>{{cite journal |author=Chi CH, Chen KW, Huang JJ, Chuang YC, Wu MH |title=Gas composition in Clostridium septicum gas gangrene |journal=J. Formos. Med. Assoc. |volume=94 |issue=12 |pages=757–9 |year=1995 |month=December |pmid=8541740 |doi= |url=}}</ref> | Gas gangrene is caused by a bacterial [[exotoxin]]-producing clostridial species, which are mostly found in soil and other anaerobes (e.g. ''[[Bacteroides]]'' and anaerobic [[Streptococcus|streptococci]]). These environmental bacteria may enter the muscle through a wound and subsequently proliferate in necrotic tissue and secrete powerful toxins. These toxins destroy nearby tissue, generating gas at the same time. A gas composition of 5.9% hydrogen, 3.4% carbon dioxide, 74.5% nitrogen and 16.1% oxygen was reported in one clinical case.<ref>{{cite journal |author=Chi CH, Chen KW, Huang JJ, Chuang YC, Wu MH |title=Gas composition in Clostridium septicum gas gangrene |journal=J. Formos. Med. Assoc. |volume=94 |issue=12 |pages=757–9 |year=1995 |month=December |pmid=8541740 |doi= |url=}}</ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Dry Gangrene
If the blood flow is interrupted for a reason other than severe bacterial infection, the result is a case of dry gangrene. People with impaired peripheral blood flow, such as diabetics, are at greater risk of contracting dry gangrene.The dark coloration is due to liberation of hemoglobin from hemolyzed red blood cells which is acted upon by hydrogen sulfide (H2S) produced by the bacteria, resulting in formation of black iron sulfide that remains in the tissues[1].
Wet Gangrene
In wet gangrene, the tissue is infected by saprogenic microorganisms (Bac.perfringes, fusiformis, putrificans, etc.), which cause tissue to swell and emit a fetid smell. Wet gangrene usually develops rapidly due to blockage of venous and/or arterial blood flow. The affected part is saturated with stagnant blood which promotes the rapid growth of bacteria. The toxic products formed by bacteria are absorbed causing systemic manifestation of septicemia and finally death.
Gas Gangrene
Gas gangrene is caused by a bacterial exotoxin-producing clostridial species, which are mostly found in soil and other anaerobes (e.g. Bacteroides and anaerobic streptococci). These environmental bacteria may enter the muscle through a wound and subsequently proliferate in necrotic tissue and secrete powerful toxins. These toxins destroy nearby tissue, generating gas at the same time. A gas composition of 5.9% hydrogen, 3.4% carbon dioxide, 74.5% nitrogen and 16.1% oxygen was reported in one clinical case.[2]