Digital gangrene in patients with sepsis

Abstract

Background: Symmetrical peripheral gangrene is a rare condition seen in patients of severe sepsis with hypotension. Gangrene is of dry type, limited to the digits only with all peripheral pulses palpable. Methods: Seven patients of severe sepsis with various etiologies were admitted in surgical ICU. These patients developed symmetrical peripheral gangrene during their stay in SICU at a variable period. Detailed history and case records were studied, and data was analyzed. Review of literature was done and compared with findings of our cases. Results: All seven patients had severe sepsis with disseminated intravascular coagulation and all seven required ventillatory support. Administration of inotropes increased the pace of ischemic process. Conclusions: Anticipation and prompt recognition of this condition can limit the progress of gangrene. Treatment is emphasized on the primary condition with focus on limiting the gangrene by local procedures.