Gangrene

Basics

Gas gangrene or clostridial myonecrosis
An acute, rapidly progressive, gas-forming necrotizing infection of healthy muscle and subcutaneous tissue
Develops contiguously from a nearby area or hematogenously
Can be seen in posttraumatic or postoperative situations
Progressive invasion and destruction of healthy muscle tissue

Clostridial organisms:
- Facultative anaerobic, spore-forming, gram-positive bacillus
- Produces a number of toxins; the most prevalent and lethal is α-toxin
Clostridium perfringens is the most common bacterium; found in 80–90% of wounds
α-toxin is largely responsible for tissue destruction
Other clostridial bacteria include C. novyi, C. septicum, C. histolyticum, C. bifermentans, and C. fallax
2 distinct mechanisms for introduction of clostridial organisms:
- Traumatic and postoperative
- Spores introduced in deep tissue, proliferate in anaerobic environment
- Nontraumatic associated with diabetes mellitus, peripheral vascular disease, alcoholism, IV drug abuse, and malignancies

There's more to see -- the rest of this topic is available only to subscribers.