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Surgery 2 - Third Year BHMS

Contents

Surgery 2 - Third Year BHMS

Contents

CoursesBHMSSurgery 2 - Third Year BHMSGANGRENE

GANGRENE

Content

Gangrene - Definition, Types, Management, and Homoeopathic Treatment

Definition of Gangrene

  • Gangrene is a serious condition that occurs when a part of the body becomes irreversibly damaged due to lack of blood supply, leading to tissue death and necrosis.
  • It can affect any part of the body, but most commonly affects the extremities, such as hands and feet.
  • Gangrene can be caused by various factors, including infections, accidents, and medical conditions.

Types of Gangrene

Wet Gangrene

  • Also known as putrid gangrene, it is caused by an infection and is characterized by the presence of pus and a foul odor.
  • It is often caused by bacterial infections such as Clostridium perfringens and is more common in the lower extremities.
  • Wet gangrene is a medical emergency and requires immediate treatment.

Dry Gangrene

  • Also known as mummification, it is caused by a lack of blood supply and is characterized by the formation of a dry, leathery eschar.
  • It is often caused by atherosclerosis or vascular disease and is more common in the upper extremities.
  • Dry gangrene is a more gradual process than wet gangrene and may not require immediate treatment.

Gas Gangrene

  • Also known as clostridial myonecrosis, it is a rare but life-threatening condition caused by the bacterium Clostridium perfringens.
  • It is characterized by the presence of gas in the tissues and is often caused by a traumatic injury.
  • Gas gangrene is a medical emergency and requires immediate treatment.

Fournier's Gangrene

  • A type of necrotizing fasciitis that affects the genital and perineal areas.
  • It is often caused by a bacterial infection and is more common in men.
  • Fournier's gangrene is a medical emergency and requires immediate treatment.

Causes of Gangrene

  • Infections, including bacterial and fungal infections
  • Accidents and trauma
  • Medical conditions, including atherosclerosis and diabetes
  • Poor circulation and vascular disease
  • Tumors and cancer

Clinical Features of Gangrene

Wet Gangrene

  • Pain and swelling in the affected area
  • Pus and a foul odor
  • Skin discoloration and softening
  • Crepitus (a grating or crunching sensation)

Dry Gangrene

  • Pain and swelling in the affected area
  • Skin discoloration and dryness
  • Eschar formation
  • Loss of sensation in the affected area

Gas Gangrene

  • Severe pain and swelling in the affected area
  • Skin discoloration and gas bubbles
  • Crepitus (a grating or crunching sensation)
  • Systemic symptoms, including fever and chills

Fournier's Gangrene

  • Severe pain and swelling in the affected area
  • Skin discoloration and crepitus
  • Necrotic tissue and eschar formation
  • Systemic symptoms, including fever and chills

Investigations for Gangrene

  • Physical examination
  • Imaging studies, including X-rays and CT scans
  • Laboratory tests, including blood cultures and tissue biopsies
  • Angiography to evaluate blood vessel damage

Management of Gangrene

Wet Gangrene

  • Antibiotics to treat the underlying infection
  • Debridement (surgical removal of dead tissue)
  • Amputation (in severe cases)
  • Hyperbaric oxygen therapy to promote healing

Dry Gangrene

  • Debridement (surgical removal of dead tissue)
  • Amputation (in severe cases)
  • Hyperbaric oxygen therapy to promote healing
  • Physical therapy to maintain mobility and prevent contractures

Gas Gangrene

  • Antibiotics to treat the underlying infection
  • Debridement (surgical removal of dead tissue)
  • Amputation (in severe cases)
  • Hyperbaric oxygen therapy to promote healing

Fournier's Gangrene

  • Antibiotics to treat the underlying infection
  • Debridement (surgical removal of dead tissue)
  • Amputation (in severe cases)
  • Hyperbaric oxygen therapy to promote healing

Homoeopathic Treatment for Gangrene

  • Arsenicum album: for symptoms of pain, swelling, and inflammation
  • Carbo vegetabilis: for symptoms of weakness, fatigue, and coldness
  • Hepar sulphuris: for symptoms of pain, swelling, and inflammation
  • Mercurius solubilis: for symptoms of pain, swelling, and inflammation
  • Silica: for symptoms of pain, swelling, and inflammation
  • Sulphur: for symptoms of pain, swelling, and inflammation
  • Thuja occidentalis: for symptoms of pain, swelling, and inflammation