Gangrene physical examination

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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

Patients with gangrene may have varying presentations depending on the type of gangrene they have.

Physical Examination

Patients with gangrene may have varying presentations depending on the type of gangrene they have.

General Appearance

Patient with gangrene usually appears conscious, coherent, and not in cardiorespiratory distress.

Vital Signs

• Blood pressure is usually low.

HEENT=

• Head: Head can be normocephalic.

• Eyes: Eyes can be normal.

• Ears:Ears can be normal.

• Nose:Nose can be normal.

• Throat: Throat can be normal.

Chest/Lungs

• • Gangrene can lead to sepsis which may manifest with decreased chest expansion, and decreased breath sounds.

Cardiovascular

• • Gangrene can lead to sepsis which may manifest with dynamic precordium, [[[irregular heart rate]], irregular rhythm, and with heart murmurs.

Abdomen

• Patients usually has no pertinent findings.

Skin/Extremities

'

Type	Skin/ Extremities Findings	Image
Dry Gangrene	The affected part is dry, shrunken, and dark black, resembling mummy/mummified flesh.	Diabetic ulceration with central "dry" gangrene and toward the edges wet gangrene with some ascending cellulitis (Image courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA) Patient with a peripheral vascular disease that has led to an infarct of several toes. Same patient. Normal left foot for comparison.
Wet Gangrene	The affected part is edematous, soft, putrid, rotten, and dark.	Diabetic with severe infection and loss of toes - wet gangrene in center. (Image courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)
Gas Gangrene	Gas gangrene can cause necrosis and gas production.

Extremities

Dry Gangrene

• The affected part is dry, shrunken and dark black, resembling mummified flesh.

• 

  Diabetic ulceration with central "dry" gangrene and toward the edges wet gangrene with some ascending cellulitis
  (Image courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)<gallery heights="175" widths="175">

• 

  Patient with peripheral vascular disease that has lead to infarct of several toes.

• 

  Same patient. Normal left foot for comparison.

</gallery>

• 

  Patient with peripheral vascular disease that has lead to infarct of several toes.

• 

  Same patient. Normal left foot for comparison.

(Images courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)

Wet Gangrene

The affected part is edematous, soft, putrid, rotten and dark.

• 

  Diabetic with severe infection and loss of toes - wet gangrene in center.
  (Image courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)

Gas Gangrene

Gas gangrene can cause necrosis and gas production.

References

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