Gangrene and Critical Limb Ischemia
- Critical Limb Ischemia (CLI) of a limb is defined as persistent and severe pain in the foot, at rest, preventing sleep, and requiring repeated analgesia. Symptom duration >4 weeks, superficial skin necrosis of the foot or digital gangrene are required to make the diagnosis. Ankle systolic blood pressure < 40mmHg in the presence of rest pain, < 60mmHg in the presence of tissue necrosis.
- Earlier definitions of CLI excluded patients with diabetes.
- WIfI: Risk stratification based on three major factors that impact amputation risk and clinical management: Wound, Ischemia, and foot Infection. Refocuses approach to the patient with diabetes who has a threatened limb and a component of chronic ischemia according to disease severity rather than arterial lesion characteristics. Not intended for application to patients with acute limb ischemia, emboli, trauma or non-atherosclerotic disease.
- Gangrene is necrosis of tissue associated with ischemia (dry gangrene) or infection (wet gangrene).
- Gas gangrene is a type of wet gangrene caused by infection with anaerobic bacteria (Clostridium) especially C. perfringens.
- Acute Limb Ischemia (ALI) is defined as a sudden decrease in limb perfusion that threatens the viability of a limb, is associated with high rates of morbidity and mortality, and requires immediate vascular surgical evaluation and intervention.
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Last updated: July 7, 2020
Shin, Laura, et al. "Gangrene and Critical Limb Ischemia." Johns Hopkins Diabetes Guide, 2020. Johns Hopkins Guides, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547056/all/Gangrene_and_Critical_Limb_Ischemia.
Shin L, Armstrong D, Sanders LJ. Gangrene and Critical Limb Ischemia. Johns Hopkins Diabetes Guide. 2020. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547056/all/Gangrene_and_Critical_Limb_Ischemia. Accessed June 9, 2023.
Shin, L., Armstrong, D., & Sanders, L. J. (2020). Gangrene and Critical Limb Ischemia. In Johns Hopkins Diabetes Guide https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547056/all/Gangrene_and_Critical_Limb_Ischemia
Shin L, Armstrong D, Sanders LJ. Gangrene and Critical Limb Ischemia [Internet]. In: Johns Hopkins Diabetes Guide. ; 2020. [cited 2023 June 09]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547056/all/Gangrene_and_Critical_Limb_Ischemia.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Gangrene and Critical Limb Ischemia ID - 547056 A1 - Shin,Laura,D.P.M., Ph.D. AU - Armstrong,David,D.P.M., M.D., Ph.D. AU - Sanders,Lee,D.P.M. Y1 - 2020/07/07/ BT - Johns Hopkins Diabetes Guide UR - https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547056/all/Gangrene_and_Critical_Limb_Ischemia DB - Johns Hopkins Guides DP - Unbound Medicine ER -