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Abstract Progressive postoperative gangrene of the skin is a rare disease which has been recognized as a clinical entity within comparatively recent times. Surgeons are indebted to Meleney for defining its characteristics and bacteriologic aspects. In Great Britain, Stewart-Wallace summed up the subject in 1935. Since publication of his paper, in which he recorded 37 cases collected in the period from 1908 to 1935, the condition has been reported about 40 times. It is still uncommon, for few surgeons have observed cases personally, and it is doubtful whether it is widely known, although it is now described in some textbooks (Dodd; Rose and Carless). This paper reports the cases of 2 patients under the care of one of us (J. W. H.). Strangely enough, these patients were treated coincidentally and were the first ones with this condition seen in an active surgical experience of thirty years. A new feature in the References 1. Eusol is a solution prepared by adding 12.5 Gm. of chlorinated lime and 12.5 Gm. of boric acid to 1 liter of water. 2. Dettol is a proprietary antiseptic derived from a coal tar product. 3. Red lotion is a solution of zinc sulfate in diluted compound tincture of lavender. 4. Alexander, E. G.: Ann. Surg. 84:461, 1926. 5. Baker, W. H., and Terry, C. C.: Case of Postoperative Progressive Gangrene of Skin , J. A. M. A. 98:138 ( (Jan. 9) ) 1932.Crossref 6. Ballin, M., and Morse, P. F.: Am. J. Surg. 11:81, 1931.Crossref 7. Blaxland, A. J.: Brit. M. J. 2:336, 1935.Crossref 8. Borelli, C.: Gior. ital. d. mal. ven. 65:326, 1924. 9. Brandberg, R.: Acta chir. Scandinav. 79:445, 1937. 10. Brewer, G. E., and Meleney, F. L.: Ann. Surg. 84:438, 1926.Crossref 11. Brunsting, L. A.; Goeckerman, W. H., and O'Leary, P. A.: Pyoderma (Echthyma): Clinical and Experimental Observations in Five Cases Occurring in Adults , Arch. Dermat. & Syph. 22:655 ( (Oct.) ) 1930. 12. Carol, W. L.: Nederl. tijdschr. v. geneesk. 76:1838, 1932. 13. Carroll, G. F.: Am. J. Surg. 41:87, 1938. 14. Christopher, F.: S. Clin. North America 4:795, 1924. 15. Brewer, G. E., and Meleney, F. L.: Tr. Am. S. A. 44:389, 1926. 16. Coakley, W. A., and Klein, S.: Am. J. Surg. 33:287, 1936. 17. Cole, W. H., and Heideman, M. L.: Amebic Ulcer of Abdominal Wall Following Appendectomy with Drainage: Report of Case , J. A. M. A. 92:537 ( (Feb. 16) ) 1929. 18. Constantinescu, M. N., and Sabaila, J.: Zentralbl. f. Chir. 65:3, 1938. 19. Cox, H. T.: Brit. J. Surg. 23:576, 1936. 20. Cullen, T. A.: Surg., Gynec. & Obst. 38:579, 1924. 21. Diebold, O.: Zentralbl. f. Chir. 61:1, 1934. 22. Dodd, H., in Maingot, R.: Postgraduate Surgery , New York, D. Appleton-Century Company, Inc., 1937, vol. 3. 23. Gillespie, M. G.: Ann. Surg. 88:284, 1928. 24. Gordon, F. N.: U. S. Vet. Bur. M. Bull. 4:1045, 1928. 25. Freeman, L.: Ann. Surg. 92:779, 1930.Crossref 26. Hicken, N. F.: Infectious Gangrene of Skin Due to Bacterial Synergism, with Particular Reference to Noma and Postoperative Cutaneous Gangrene , Arch. Surg. 31:253 ( (Aug.) ) 1935.Crossref 27. Holman, E.: Surg., Gynec. & Obst. 60:304, 1935. 28. Jaeger, F.: Zentralbl. f. Chir. 65:3, 1938. 29. Kappis, M.: Beitr. z. klin. Chir. 155:179, 1932. 30. Kueppers, H.: Zentralbl. f. Chir. 62:1, 1935. 31. Liedberg, N.: Acta chir. Scandinav. 77:354 and 378, 1936. 32. Lynn, F. S.: Postoperative Gangrenous Ulcer of Abdominal Wall , J. A. M. A. 97:1597 ( (Nov. 28) ) 1931. 33. Mayeda, T.: Deutsche Ztschr. f. Chir. 99:350, 1926. 34. Meleney, F. L.: Ann. Surg. 94:961, 1931 35. Surg., Gynec. & Obst. 56:874, 1933. 36. Mitchell, J. F., cited by Lynn. 37. Brewer, G. E., and Meleney, F. L.: Tr. Am. S. A. 44:389, 1926. 38. Nightingale, H. J., and Bowden, E. C.: Brit. J. Surg. 22:392, 1934. 39. Patterson, A. P.: Ann. Surg. 96:1091, 1932. 40. Philipowicz, I.: Centralbl. f. Chir. 63:799, 1936. 41. Poate, R. G.: M. J. Australia 2:398, 1930. 42. Poerschke, A.: Zentralbl. f. Chir. 64:2283, 1938. 43. Brewer, G. E., and Meleney, F. L.: Tr. Am. S. A. 64:389, 1926. 44. Probstein, J. G., and Seelig, M. G.: Surg., Gynec. & Obst. 47:247, 1928. 45. Rose, W., and Carless, A.: Manual of Surgery , ed. 8, London, Baillière, Tyndall & Cox, 1911, p. 113. 46. Schlink, H. H., and Thomson, E. F.: M. J. Australia 2:625, 1935. 47. Scotson, F. H.: Lancet 1:80, 1933.Crossref 48. Shipley, A. N.: Ann. Surg. 87:245, 1928.Crossref 49. Stewart-Wallace, A. M.: Brit. J. Surg. 22:642, 1935.Crossref 50. Stohr, R., and Niederland, W.: Deutsche Ztschr. f. Chir. 245:321, 1935.Crossref 51. Sussi, L.: Ann. ital. di chir. 16:487, 1937 52. abstracted, Chirurg 10:669, 1938. 53. Syme, G. R. A.: M. J. Australia 2:98, 1936. 54. Syme and Bryce, L.: Roy. Melbourne Clin. Rep. , 1936, vol. 7. 55. Tennant, C. E., cited by Freeman. 56. Tixier, Pollosson and Arnulf, G.: Presse méd. 45:1163, 1937. 57. Wachs, E.: Beitr. z. klin. Chir. 165:564, 1937. 58. Wakeley, C. P. G., and Willway, F. W.: Brit. J. Surg. 25:451, 1937.Crossref 59. Waschulewski, H.: Zentralbl. f. Chir. 66:1, 1939. 60. Willard, H. G.: Ann. Surg. 104:226, 1936.Crossref 61. Wolanski, R.: Wien. med. Wchnschr. 89:61, 1939.
Archives of Surgery – American Medical Association
Published: Jun 1, 1941
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