Sunday, January 15, 2006


Gangrene is the deterioration and death of tissue associated with loss of the vascular supply followed by bacterial invasion. In old age, most cases of gangrene are caused by blockage in the circulation in either the arteries or the veins. It may occur acutely after an arterial embolus (detached clot) or be the culmination of a progressive arteriosclerotic obliteration (narrowing and occlusion of arterial lumen) of limb vessels. A history of sudden onset of pain and paralysis, in conjunction with signs of a mottled, cold, pulseless limb is sufficient to diagnose embolic occlusion. A history of coronary thrombosis and an irregular pulse would explain the source of the embolus (heart) and confirm the diagnosis. If the condition is recognized and treatment initiated early enough, the limb can be saved. When gangrene is established, the only course is to amputate.
Brocklehurst, J. C. Geriatric Medicine and Gerontology, 3rd ed. New York: Churchill Livingstone, 1985.


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