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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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Rosen, Peter, et al., editors. "Gangrene." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307533/all/Gangrene.
Gangrene. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307533/all/Gangrene. Accessed April 25, 2019.
Gangrene. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307533/all/Gangrene
Gangrene [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307533/all/Gangrene.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Gangrene ID - 307533 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307533/all/Gangrene PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -