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Article
August 1935

INFECTIOUS GANGRENE OF THE SKIN DUE TO BACTERIAL SYNERGISM: WITH PARTICULAR REFERENCE TO NOMA AND POSTOPERATIVE CUTANEOUS GANGRENE

Author Affiliations

OMAHA
From the Departments of Anatomy and Surgery, University of Nebraska.

Arch Surg. 1935;31(2):253-265. doi:10.1001/archsurg.1935.01180140081006
Abstract

Gangrenous infections of the skin and subcutaneous tissues are much more common than is usually appreciated. These necrotizing processes develop rapidly, destroying the involved tissues and jeopardizing the lives of the patients. Fusospirochetal, amebic and streptococcic infections, ecthyma, gas gangrene and phagedenic ulcers of the thoracic and abdominal walls following operations for suppurative processes are the most common clinical expressions of bacterial gangrene of the skin.

Accurate diagnosis and scientific treatment depend on the identification of the invading organisms as well as on an appreciation of the local tissue reaction and the systemic response to such infections. Meleney1 maintained that complete bacteriologic studies, employing anaerobic as well as aerobic methods, are necessary if one expects to isolate the provocative organisms. Cultures should be made from biopsy specimens taken from various areas of the lesion. By such painstaking bacteriologic examination, he has demonstrated that a bacterial synergism, or a symbiotic

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