dry gangrene
Introduction
Introduction Dry gangrene is mostly found at the extremities of the extremities, such as atherosclerosis, thromboangiitis obliterans, and frostbite. At this time, the artery is blocked and the venous return is smooth, so the necrotic tissue has less water, and the surface water is easy to evaporate, causing the lesion to dry and shrink, showing a dark brown color, and there is a clear boundary line with the surrounding healthy tissue. Since necrotic tissue is relatively dry, spoilage infections are generally mild. Mostly found at the extremities of the extremities, such as atherosclerosis, thromboangiitis obliterans and frostbite. At this time, the artery is blocked and the venous return is smooth, so the necrotic tissue has less water, and the surface water is easy to evaporate, causing the lesion to dry and shrink, showing a dark brown color, and there is a clear boundary line with the surrounding healthy tissue.
Cause
Cause
Cause:
After gangrene tissue necrosis, it has special morphological changes such as black and dark green due to the infection of secondary spoilage bacteria and other factors. The necrotic tissue is decomposed by spoilage bacteria to produce hydrogen sulfide, which combines with the iron decomposed in hemoglobin to form iron sulfide, making the necrotic tissue black.
1, dry gangrene (dry gangrene) is mostly seen at the extremities of the extremities, such as atherosclerosis, thromboangiitis obliterans and frostbite. At this time, the artery is blocked and the venous return is smooth, so the necrotic tissue has less water, and the surface water is easy to evaporate, causing the lesion to dry and shrink, showing a dark brown color, and there is a clear boundary line with the surrounding healthy tissue. Since necrotic tissue is relatively dry, spoilage infections are generally mild.
2, wet gangrene (wet gangrene) wet gangrene often occurs in the internal organs (intestines, uterus, lungs, etc.), can also be seen in the limbs (with congestion and edema). At this time, due to the high water content of the necrotic tissue, the spoilage bacteria are seriously infected, and the local area is obviously swollen, and it is dark green or dirty black. The spoilage bacteria break down proteins, produce sputum, skatole, etc., causing bad odor. Because the lesions develop faster and the inflammation is more diffuse, there is no obvious dividing line between the necrotic tissue and the healthy tissue. At the same time, the toxic products and bacterial toxins produced by tissue necrosis can be absorbed, which can cause symptoms of systemic poisoning and even death due to toxic shock. Common wet gangrene have gangrenous appendicitis, intestinal gangrene, lung gangrene and postpartum gangrenous endometritis.
3, gas gangrene (gas gangrene) seen in the invasion of traumatic wounds caused by gastrobacter bacilli, rapid development and serious consequences, may be gas or no gas. The incubation period is 6 hours to 6 days. The clinical symptoms are swelling and severe pain. The wound begins to be red and swollen, and the skin is pale and intense. Then the wound turns purple-black, blisters with dark red liquid appear, and the malodorous liquid can flow out. The muscles in the wound are dark red and swollen, losing elasticity, and the knife does not shrink or bleed. Systemic symptoms including toxemia appear later. The main treatment measures are debridement and drainage, antibiotics, hyperbaric oxygen chamber, and amputation should be performed when necessary to enhance the survival rate of patients. Gas gangrene is a serious acute specific infection caused by Clostridium anaerobic bacteria. The pathogens mainly grow and reproduce in the wound, and the tissue inside the wound is necrotic and corrosive, which produces an anaerobic environment, which is more conducive to bacterial reproduction, and the disease is rapidly deteriorated. The principle of treatment is to remove the muscle tissue without vitality as soon as possible, and the lesions are extensively and cut in many places; open the wound; rinse with oxidizing agent and wet compress to change the anaerobic environment.
Examine
an examination
Related inspection
Special bacterial smear examination routine urine routine anaerobic bacteria test routine
Clinically, patients with dry gangrene should be examined:
First, physical examination
Taking a medical history gives us a first impression and revelation, and also guides us to a concept of the nature of the disease.
Second, laboratory inspection
Laboratory examinations must be summarized and analyzed based on objective materials and medical examinations, and several possible diagnostics are proposed, and then further examinations are performed to confirm the diagnosis.
Diagnosis
Differential diagnosis
Differential diagnosis of dry gangrene:
1. Wet gangrene Wet gangrene occurs mostly in the internal organs (intestines, uterus, lungs, etc.) that are connected to the outside world, and can also be found in limbs (when accompanied by congestion and edema). At this time, due to the high water content of the necrotic tissue, the spoilage bacteria are seriously infected, and the local area is obviously swollen, and it is dark green or dirty black. The spoilage bacteria break down proteins, produce sputum, skatole, etc., causing bad odor. Because the lesions develop faster and the inflammation is more diffuse, there is no obvious dividing line between the necrotic tissue and the healthy tissue. At the same time, the toxic products and bacterial toxins produced by tissue necrosis can be absorbed, which can cause symptoms of systemic poisoning and even death due to toxic shock. Common wet gangrene have gangrenous appendicitis, intestinal gangrene, lung gangrene and postpartum gangrenous endometritis.
2, gas gangrene (gas gangrene) is a special type of wet gangrene, mainly seen in severe deep muscle trauma and combined with anaerobic infections such as Clostridium perfringens. When the bacteria break down the necrotic tissue, a large amount of gas is generated, so that the necrotic tissue contains a large amount of air bubbles, and there is a "burst" sound. Gastric gangrene lesions develop rapidly, the symptoms of poisoning are obvious, and the consequences are serious, requiring urgent treatment.
