Gangrene other diagnostic studies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Edzel Lorraine Co, D.M.D., M.D.

There are some useful tools that were developed to assess for the possibility of gangrene. These include the recent development of the Society of Vascular Surgery which is called WIfI which stands for wound, ischemia, foot infection ^[1], and the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score ^{[2] [3]}.

• There are some useful tools were developed to assess the possibility of gangrene.
• These include:
  • WIfI (wound, ischemia, foot infection) Classification ^[1]
    • This can anticipate the need for revascularization if the result shows a high risk for amputation.
    • Score can range from 0 to 3.
    • Score of 1 is given to a salvageable minor tissue loss by doing a simple amputation.
    • Score of 2 is given to multiple digital amputations or transmetatarsal amputations.
    • Score of 3 signifies an extensive tissue loss requiring extensive amputation.
      
  • Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score ^{[2] [3]}.
    • This is based on the results of complete blood count, sodium level, glucose level, C-reactive protein, and creatinine. ^{[2] [3]}
    • Increased mortality in these patients with gangrene is suggested by the following ^{[4] [5] [6] [7]}:
      • Increased age (>60 years old)
      • Clostridial infection
      • Head, neck, abdomen, or thoracic involvement
      • Leukocytosis (White blood cell count of more than 30,000 per microliters, and band neutrophils of more than 10 percent)
      • Serum creatinine of more than 2.0 mg/dL
      • Delayed surgical treatment for more than 24 hours.