Infective cutaneous gangrene--urgency in diagnosis and treatment

Many descriptions of infective cutaneous gangrene have been published under a variety of names. The classification adopted by Ledingham and Tehrani is illustrated by 4 cases seen in the Stoke Mandeville Hospital. Although the incidence is high in Eastern countries, infective cutaneous gangrene is uncommon in the Western hemisphere owing to a difference in geographic pathology. Early and delayed management is described, stressing that early diagnosis and aggressive treatment is required, ideally by a team consisting of a microbiologist and plastic and general surgeons. There is a substantial risk associated with the failure to diagnose and treat this condition. Mortality rates and prognosis are reviewed.