Transcript gangrene + cellulitis - faculty at Chemeketa

GANGRENE
+
CELLULITIS
TYPES OF GANGRENE
DRY GANGRENE:
– CAUSED BY
REDUCTION OF
BLOOD FLOW
THROUGH THE
ARTERIES.
– APPEARS
GRADUALLY
– TISSUE SLOWLY
DIES
– THE SKIN DRYS OUT
AND WITHERS
DRY GANGRENE SYMPTOMS:
– THE SITE NEVER BECOMES INFECTED SO
ONSET IS SLOW
– FIRST SIGNS ARE USUALLY NUMBNESS
AND TINGLING FOLLOWED BY SEVERE
PAIN
– SKIN TEMP. DROPS, SKIN COLOR
CHANGES, EVENTUALLY TURNS BLACK
WET GANGRENE:
– CAN DEVELOP FROM AN UNTREATED
WOUND
– BACTERIAL INFECTION SETS IN
– SWELLING FROM THE INFECTION CAN
CAUSE STOPPAGE OF BLOOD FLOW
– CESSATION OF BLOOD FLOW HELPS
PROPIGATE BACTERIAL SPREAD
BECAUSE WHITE BLOOD CELLS CAN NOT
REACH THE INFECTED AREA.
WET GANGRENE SYMPTOMS:
– ONCE THE BLOOD FLOW STOPS DUE TO
INJURY, BACTERIA SETS IN, USUALLY;
STREPTOCOCCOUS AND
STAPHYLOCOCCOUS BACTERIA.
– THERE IS PAIN, SWELLING, BLISTERING
OF THE SKIN
– THE WOUND GIVES OFF A FOUL SMELL
– WET GANGRENE CAN BE FATAL
GAS GANGRENE:
– THIS IS A FORM OF WET GANGRENE
– AFFECTS THE DEEP MUSCLE TISSUE
– CAUSED BY AN INFECTION BY THE
BACTERIA CLOSTRIDIUM PERFRINGENS
THRIVES IN ANAEROBIC CONDITIONS
– DEVELOPS IN AN INJURY OR SURGICAL
WOUND THAT’S DEPLETED OF BLOOD
– PRODUCES TOXINS THAT RELEASE GAS
GAS GANGRENE SYMPTOMS
– MARKED BY A HIGH
FEVER
– BROWNISH PUS
– GAS BUBBLES
UNDER THE SKIN
– SKIN
DISCOLORATION
– A FOUL ODOR
– RAREST FORM1,000-3,000 CASES
/YR.
INTERNAL GANGRENE:
– MOST COMMON IN GALL BLADDER,
SMALL INTESTINES ,OR THE APPENDIX
– BLOOD FLOW TO THE ORGANS IS
DEPLETED
– ORGANS BULGE THROUGH A WEAKENED
PORTION OF THE ABDOMINAL MUSCLES
CAUSING THEM TO BECOME TWISTED
– CAUSES FEVER AND SEVERE PAIN
FOURNIERS GANGRENE:
– INVOLVES THE GENITAL ORGANS
– MORE COMMON IN MEN THAN IN WOMAN
– THE INFECTION IS IN THE GENITAL AREA
OR IN THE URNIARY TRACT
RISK FACTORS:
– AGE: GANGRENE HAPPENS MORE
OFTEN IN ELDERLY
– DIABETES: CAUSES DAMAGE TO BLOOD
VESSELS RESTRICTING BLOOD FLOW
– BLOOD VESSEL DISEASE: HARDENED
OR NARROWED ARTERIES
(ARTHERIOSCLEROSIS) OR BLOOD
CLOTS CAN BLOCK BLOOD FLOW
MORE RISK FACTORS:
– SEVERE INJURY OR SURGERY: ANY
PROCESS THAT CAUSES TRAUMA TO
YOUR SKIN OR UNDERLYING TISSUE
INCREASES RISK ( FROSTBITE,
CRUSHING INJURY, ETC.)
– IMMUNOSUPPRESSION: (HIV) OR THOSE
UNDERGOING CHEMO. OR RADIATION
GREATLY REDUCES THE BODYS ABILITY
TO FIGHT INFECTION
HOW TO DIAGNOSE GANGRENE:
– PHYSICAL EXAMINATION
– PATIENTS MEDICAL HISTORY
– BLOOD AND LAB TESTS
CULTURES FROM THE INFECTED AREA MAY
BE TAKEN TO FIND OUT WHAT TYPE OF
GANGRENE IT IS.
WHEN TO BE CONCERNED!
– PERSISTENT, UNEXPLAINED PAIN
– PERSISTENT FEVER
– WOUND THAT’S SLOW TO HEAL
– FOUL-SMELLING DISCHARGE FROM A
WOUND
– SKIN THAT’’S BECOME PALE, HARD,
COLD, AND NUMB
HOW TO TREAT GANGRENE:
– NO MATTER WHAT FORM OF GANGRENE
IT IS, DYING TISSUE MUST BE REMOVED
BY A PROCEDURE CALLED
DEBRIDEMENT
– LARGE AMOUNTS OF ANTIBIOTICS
– POSSIBLE AMPUTATION IN EXTREME
CASES
– HYPERBARIC CHAMBER ON OCCASION
FLOOD THE BACTERIA WITH O2
HYPERBARIC CHAMBER
WHO’S COMING TO DINNER?
MAGGOT THERAPY USES THESE
UNSIGHTLY LITTLE CRITTERS TO EAT
THE DEAD FLESH AND LEAVE THE GOOD
CAN YOU PREVENT GANGRENE?
– CAREFULL CLEANING AND WATCHING
WOUNDS FOR SIGNS OF INFECTION
– SEEK MEDICAL ATTENTION FOR ANY
WOUNDS THAT ARE NOT HEALING OR
LOOK INFECTED
– THOSE WITH RISK FACTORS NEED TO
PAY EXTRA ATTENTION TO ANY SKIN
INFECTIONS ON THEIR LEGS OR FEET
– AVOID SMOKING
CELLULITIS
AN INFLAMATION
OF THE
CONNECTIVE
TISSUE
UNDERLYING THE
SKIN, THAT CAN BE
CAUSED BY A
BACTERIAL
INFECTION.
CAUSES OF CELLULITIS:
– BACTERIA ENTERING A BREAK IN THE
SKIN
– MOST COMMON BACTERIA ARE
STREPTOCOCCUS AND STAPHYLOCOCCUS
– BOTH OF THESE BACTERIA ARE
HARMLESS UNTIL THEY FIND AN
OPENING IN THE SKIN
THE DARK SIDE!
– IN MANY CASES THE INFECTION IS
NOTHING MORE THAN A RASH
– REDDENED SKIN CAN BE A SIGN TO
SOMETHING MUCH MORE SERIOUS,
ONCE THE INFECTION MOVES INTO THE
INNER LAYERS OF THE SKIN IT CAN
SPREAD RAPIDLY
THE DARK SIDE CONT!
– THE INFECTION CAN ENTER THE LYMPH
NODES AND THE BLOODSTREAM AND
SPREAD THROUGHOUT THE BODY
– IN RARE CASES THE INFECTION MOVES
INTO THE DEEP TISSUE AND
BECOMES”NECROTIZING FASCIITIS”
NECROTIZING FASCIITIS
RISK FACTORS!
– ELDERLY
– THOSE WITH WEAKENED IMMUNE
SYSTEMS
– DIABETES
– IMMUNOSUPPRESSIVE DRUGS AND HIV
– CHICKENPOX AND SHINGLES
INCUBATION AND DURATION.
– CELLULITIS CAN DEVELOP IN AS LITTLE
AS 24 HOURS OR TAKE DAYS
– IN MOST CASES IT TAKES LESS THAN A
WEEK TO DISAPEAR
– IN MORE SERIOUS CASES IT CAN TAKE
MONTHS
– RARE CASES IT CAN LEAVE DISABILITIES
OR EVEN CAUSE DEATH
DIAGNOSIS AND TREATMENT
– DIAGNOSIS CAN ONLY HAPPEN IN THE
HOSPITAL SETTING WITH NUMEROUS
TESTS
– ANTIBIOTICS, ANTIBIOTICS, ANTIBIOTICS,
ANTIBIOTICS, FLUIDS AND BED REST