Gangrene is a topic covered in the 5-Minute Emergency Consult.

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  • Gas gangrene or clostridial myonecrosis
  • An acute, rapidly progressive, gas-forming necrotizing infection of muscle and subcutaneous tissue
  • Can be seen in post-traumatic 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.
  • Other clostridial bacteria include Clostridium novyi, Clostridium septicum, Clostridium histolyticum, Clostridium bifermentans, and Clostridium fallax.
  • 2 distinct mechanisms for introduction of clostridial organisms:
    • Traumatic and postoperative
    • Nontraumatic associated with diabetes mellitus, peripheral vascular disease, alcoholism, IV drug abuse, and malignancies

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