Quotation from: Manual of SurgeryWritten by: Alexander Miles and Alexis Thomson |
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#Clinical Varieties of Bacillary Gangrene.#--#Acute infective gangrene# is the form most commonly met with in civil practice. It may follow such trivial injuries as a pin-prick or a scratch, the signs of acute cellulitis rapidly giving place to those of a spreading gangrene. Or it may ensue on a severe railway, machinery, or street accident, when lacerated and bruised tissues are contaminated with gross dirt. Often within a few hours of the injury the whole part rapidly becomes painful, swollen, oedematous, and tense. The skin is at first glazed, and perhaps paler than normal, but soon assumes a dull red or purplish hue, and bullae form on the surface. Putrefactive gases may be evolved in the tissues, and their presence is indicated by emphysematous crackling when the part is handled. The spread of the disease is so rapid that its progress is quite visible from hour to hour, and may be traced by the occurrence of red lines along the course of the lymphatics of the limb. In the most acute cases the death of the affected part takes place so rapidly that the local changes indicative of gangrene have not time to occur, and the fact that the part is dead may be overlooked.
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