Prevention of Gangrene Wounds
Gangrene (necrosis) of tissue is a complication, not an initial condition that can be prevented. On-going risk factors that make it more likely, if ordinarily addressable infections begin, should be mitigated–smoking and circulatory compromise. For diabetics, this means strict glycemic control and immediate, aggressive identification and management of bedsores and pressure ulcers over bony prominences.
Prevention in the Patient with a Gangrene Wound
Those conditions that promote necrosis in infected tissues should be addressed in the often frustrating task of defeating gangrene before there is any more loss of tissue. This strategy is implemented while aggressively treating the gangrene (necrosis of tissue, fascia, and/or muscle) with persistent surgical debridement of necrotic tissue and rational antibiotic coverage.
During any phase of therapy–early or later–good nutrition is critical for re-establishment of tissue integrity that otherwise might fail with the progressive necrosis.
Anything that may negatively impact circulation, such as smoking or illicit use of sympathomimetics such as cocaine or methamphetamines, should be discontinued immediately as a life-and-death decision.
Prevention in Close Contacts of the Patient with a Gangrene Wound
Besides the patient him- or herself, any close contact with the afflicted patient is at risk of becoming a secondary case when group A Streptococcus is involved. For these individuals, prophylactic antibiotics are prudent if they are at increased risk due to diabetes or immunosuppression (chemotherapy, transplant patients, HIV).