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{{Gangrene}}
{{Gangrene}}
{{CMG}}; {{AE}} [[User:Edzelco|Edzel Lorraine Co, D.M.D., M.D.]]
{{CMG}}; {{AE}} [[User:Edzelco|Edzel Lorraine Co, D.M.D., M.D.]]


==Overview==
==Overview==
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==Other Diagnostic Studies==
==Other Diagnostic Studies==


*There are some useful tools that were developed to assess for the possibility of [[gangrene]].
*There are some useful tools were developed to assess the possibility of [[gangrene]].
*These include:
*These include:
**<u>[[WIfI]] ([[wound]], [[ischemia]], [[foot infection]]) Classification <ref name="pmid25439329">{{cite journal| author=Elsayed S, Clavijo LC| title=Critical limb ischemia. | journal=Cardiol Clin | year= 2015 | volume= 33 | issue= 1 | pages= 37-47 | pmid=25439329 | doi=10.1016/j.ccl.2014.09.008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25439329  }} </ref></u>
**<u>'''[[WIfI]] ([[wound]], [[ischemia]], [[foot infection]]) Classification''' <ref name="pmid25439329">{{cite journal| author=Elsayed S, Clavijo LC| title=Critical limb ischemia. | journal=Cardiol Clin | year= 2015 | volume= 33 | issue= 1 | pages= 37-47 | pmid=25439329 | doi=10.1016/j.ccl.2014.09.008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25439329  }} </ref></u>
***This can anticipate the need for [[revascularization]] if the result shows a high risk for [[amputation]].
***This can anticipate the need for [[revascularization]] if the result shows a high risk for [[amputation]].
***Score can range from 0 to 3Score of 1 is given to a [[salvageable]] minor [[tissue]] loss by doing a [[simple amputation]].
***Score can range from 0 to 3.
***Score of 1 is given to a [[salvageable]] minor [[tissue]] loss by doing a [[simple amputation]].
***Score of 2 is given to multiple [[digital amputations]] or [[transmetatarsal amputations]].
***Score of 2 is given to multiple [[digital amputations]] or [[transmetatarsal amputations]].
***Score of 3 signifies an extensive [[tissue loss]] requiring extensive [[amputation]].
***Score of 3 signifies an extensive [[tissue loss]] requiring extensive [[amputation]].<br>
**<u>Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score</u> <ref name="pmid15241098">{{cite journal| author=Wong CH, Khin LW, Heng KS, Tan KC, Low CO| title=The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. | journal=Crit Care Med | year= 2004 | volume= 32 | issue= 7 | pages= 1535-41 | pmid=15241098 | doi=10.1097/01.ccm.0000129486.35458.7d | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15241098  }} </ref> <ref name="pmid34039397">{{cite journal| author=Wu PH, Wu KH, Hsiao CT, Wu SR, Chang CP| title=Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections. | journal=World J Emerg Surg | year= 2021 | volume= 16 | issue= 1 | pages= 26 | pmid=34039397 | doi=10.1186/s13017-021-00373-0 | pmc=8157441 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34039397  }} </ref>.
**<u>'''Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score'''</u> <ref name="pmid15241098">{{cite journal| author=Wong CH, Khin LW, Heng KS, Tan KC, Low CO| title=The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. | journal=Crit Care Med | year= 2004 | volume= 32 | issue= 7 | pages= 1535-41 | pmid=15241098 | doi=10.1097/01.ccm.0000129486.35458.7d | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15241098  }} </ref> <ref name="pmid34039397">{{cite journal| author=Wu PH, Wu KH, Hsiao CT, Wu SR, Chang CP| title=Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections. | journal=World J Emerg Surg | year= 2021 | volume= 16 | issue= 1 | pages= 26 | pmid=34039397 | doi=10.1186/s13017-021-00373-0 | pmc=8157441 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34039397  }} </ref>.
***This is based on the results of [[complete blood count]], [[sodium level]], [[glucose level]], [[C-reactive protein]], and [[creatinine]]. <ref name="pmid15241098">{{cite journal| author=Wong CH, Khin LW, Heng KS, Tan KC, Low CO| title=The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections. | journal=Crit Care Med | year= 2004 | volume= 32 | issue= 7 | pages= 1535-41 | pmid=15241098 | doi=10.1097/01.ccm.0000129486.35458.7d | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15241098  }} </ref> <ref name="pmid34039397">{{cite journal| author=Wu PH, Wu KH, Hsiao CT, Wu SR, Chang CP| title=Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections. | journal=World J Emerg Surg | year= 2021 | volume= 16 | issue= 1 | pages= 26 | pmid=34039397 | doi=10.1186/s13017-021-00373-0 | pmc=8157441 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34039397  }} </ref>
***Increased [[mortality]] in these [[patients]] with [[gangrene]] is suggested by the following <ref name="pmid12925624">{{cite journal| author=Wong CH, Chang HC, Pasupathy S, Khin LW, Tan JL, Low CO| title=Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. | journal=J Bone Joint Surg Am | year= 2003 | volume= 85 | issue= 8 | pages= 1454-60 | pmid=12925624 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12925624  }} </ref> <ref name="pmid17638193">{{cite journal| author=Darenberg J, Luca-Harari B, Jasir A, Sandgren A, Pettersson H, Schalén C | display-authors=etal| title=Molecular and clinical characteristics of invasive group A streptococcal infection in Sweden. | journal=Clin Infect Dis | year= 2007 | volume= 45 | issue= 4 | pages= 450-8 | pmid=17638193 | doi=10.1086/519936 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17638193  }} </ref> <ref name="pmid15723996">{{cite journal| author=Anaya DA, McMahon K, Nathens AB, Sullivan SR, Foy H, Bulger E| title=Predictors of mortality and limb loss in necrotizing soft tissue infections. | journal=Arch Surg | year= 2005 | volume= 140 | issue= 2 | pages= 151-7; discussion 158 | pmid=15723996 | doi=10.1001/archsurg.140.2.151 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15723996  }} </ref> <ref name="pmid21825948">{{cite journal| author=Huang KF, Hung MH, Lin YS, Lu CL, Liu C, Chen CC | display-authors=etal| title=Independent predictors of mortality for necrotizing fasciitis: a retrospective analysis in a single institution. | journal=J Trauma | year= 2011 | volume= 71 | issue= 2 | pages= 467-73; discussion 473 | pmid=21825948 | doi=10.1097/TA.0b013e318220d7fa | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21825948  }} </ref>:
****Increased [[age]] (>60 years old)
****''[[Clostridial]]'' [[infection]]
****[[Head]], [[neck]], [[abdomen]], or [[thoracic]] involvement
****[[Leukocytosis]] ([[White blood cell count]] of more than 30,000 per microliters, and [[band neutrophils]] of more than 10 percent)
****[[Serum creatinine]] of more than 2.0 mg/dL
****Delayed [[surgical treatment]] for more than 24 hours.


==References==
==References==
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Latest revision as of 17:45, 14 July 2022

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Edzel Lorraine Co, D.M.D., M.D.

Overview

There are some useful tools that were developed to assess for the possibility of gangrene. These include the recent development of the Society of Vascular Surgery which is called WIfI which stands for wound, ischemia, foot infection [1], and the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score [2] [3].

Other Diagnostic Studies

References

  1. 1.0 1.1 Elsayed S, Clavijo LC (2015). "Critical limb ischemia". Cardiol Clin. 33 (1): 37–47. doi:10.1016/j.ccl.2014.09.008. PMID 25439329.
  2. 2.0 2.1 2.2 Wong CH, Khin LW, Heng KS, Tan KC, Low CO (2004). "The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections". Crit Care Med. 32 (7): 1535–41. doi:10.1097/01.ccm.0000129486.35458.7d. PMID 15241098.
  3. 3.0 3.1 3.2 Wu PH, Wu KH, Hsiao CT, Wu SR, Chang CP (2021). "Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections". World J Emerg Surg. 16 (1): 26. doi:10.1186/s13017-021-00373-0. PMC 8157441 Check |pmc= value (help). PMID 34039397 Check |pmid= value (help).
  4. Wong CH, Chang HC, Pasupathy S, Khin LW, Tan JL, Low CO (2003). "Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality". J Bone Joint Surg Am. 85 (8): 1454–60. PMID 12925624.
  5. Darenberg J, Luca-Harari B, Jasir A, Sandgren A, Pettersson H, Schalén C; et al. (2007). "Molecular and clinical characteristics of invasive group A streptococcal infection in Sweden". Clin Infect Dis. 45 (4): 450–8. doi:10.1086/519936. PMID 17638193.
  6. Anaya DA, McMahon K, Nathens AB, Sullivan SR, Foy H, Bulger E (2005). "Predictors of mortality and limb loss in necrotizing soft tissue infections". Arch Surg. 140 (2): 151–7, discussion 158. doi:10.1001/archsurg.140.2.151. PMID 15723996.
  7. Huang KF, Hung MH, Lin YS, Lu CL, Liu C, Chen CC; et al. (2011). "Independent predictors of mortality for necrotizing fasciitis: a retrospective analysis in a single institution". J Trauma. 71 (2): 467–73, discussion 473. doi:10.1097/TA.0b013e318220d7fa. PMID 21825948.