What is Gangrene?
Gangrene is a fatal condition that develops when blood flow to a large tissue area is interrupted, causing the tissue to deteriorate and die. Gangrene usually causes the affected skin to turn greenish-black and can damage internal organs.
Usually, the condition begins in a single body part, such as a leg, hand, or internal organ. If left untreated, gangrene can spread throughout the body and result in a septic shock. Septic shock is a life-threatening medical emergency when
sepsis leads to a severe drop in
blood pressure.
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How many Types of Gangrene are there?
- Dry gangrene
- Wet gangrene
- Gas gangrene
What are the Symptoms of Gangrene?
Gangrene symptoms include the following:
Dry gangrene:
- The affected area is painful.
- It becomes red at first, then turns dark and shrivelled.
- The infected area becomes cold and numb
Wet or moist gangrene:
- It is extremely painful.
- The affected area becomes swollen and decayed.
- It produces a foul-smelling odour.
- It becomes black with blisters oozing fluid.
- The affected person develops a fever.
Gas gangrene:
- It is a type of wet gangrene.
- The damaged tissues may leak a brown-red or bloody discharge.
- The wound becomes infected.
- It gets inflamed, and blisters may form.
- When the infected area is pressed, the gas released by Clostridia may provide a crackling feeling.
- The infected region is in excruciating pain.
- If the toxins enter the blood circulation, the infected person has a fever,
increased heart rate, and fast breathing.
When to see a doctor?
Gangrene is a dangerous condition that needs immediate medical attention. See the doctor immediately if you have chronic, unexplained pain in any body part and one or more of the following signs and symptoms.
- Some parts of the body become blue or black.
- Wounds do not heal in seven to fourteen days.
- Localized pain is excruciating.
- The unexplained fever persists for a long time.
- Blood or pus flows from the wound.
- An unpleasant odour emanates from the wound.
Consult our general surgeon for more information and adequate treatment for gangrene.
What are the Causes of Gangrene?
A decreased blood flow causes all types of gangrene to a specific area. This deprives the tissue of oxygen and nutrients, causing it to die.
- Dry forms can also result from:
- Severe burns, scalds, and cold: Dry gangrene can be caused by heat, chemical agents, and extreme cold, including frostbite. Wet gangrene may form later.
- Vascular problems: Vascular issues are most typically caused by the poor health of the arteries and veins in the legs and toes. The common causes are diabetes,
peripheral arterial disease, and
hypertension.
- Diabetes: Blood sugar imbalance can damage blood vessels and neurons, limiting oxygen delivery to the extremities.
- Raynaud’s disease: Circulation to the tips of the fingers and toes is obstructed, particularly in cold temperatures. Raynaud's phenomenon has been linked to some occurrences of gangrene.
- Wet forms can develop from:
- Injury: Deep, crushing, or penetrating wounds that allow bacterial infection can lead to gangrene. Examples are war zones, accidents involving railways or machinery, and street accidents.
- Immune deficiency: When a person's immune system is compromised due to HIV, diabetes, long-term alcohol or drug addiction, recent chemotherapy or radiotherapy, or mild infections that progress quickly, all these factors can make a person prone to gangrene.
- Embolism: A sudden blockage of an artery can cause dry gangrene, but it also increases the risk of infection and, therefore, leads to wet gangrene.
What are the Risk factors of Gangrene?
Things that can make gangrene more likely include:
- Diabetes: High blood sugar levels can harm blood vessels over time, slowing or blocking blood flow to body parts.
- Blood vessel disease: Conditions like hardened arteries and blood clots can block blood flow to certain areas.
- Severe injury or surgery: Any injury or surgery that damages skin and tissue, such as frostbite, raises the risk of gangrene, especially if blood flow is already affected.
- Smoking: Smoking increases the risk of gangrene.
- Obesity: Extra weight can put pressure on arteries, slowing blood flow and making infections and wound healing harder.
- Immunosuppression: Treatments like chemotherapy and radiation, as well as infections like HIV, weaken the body's ability to fight infections.
- Injections: Rarely, injectable drugs can lead to infections that cause gangrene.
- COVID-19 complications: Some people who had COVID-19 and experienced blood clotting issues later developed dry gangrene in their fingers and toes. More research is needed to understand this connection fully.
What are the Complications of Gangrene?
If an infection enters the bloodstream, it will lead to bacteraemia (spread of bacterial infection into the bloodstream and distant organs) and the development of sepsis and septic shock, which requires immediate medical attention. The complications include:
How to Prevent Gangrene?
The preventive measures to lower the risk of gangrene include:
- Once a year, have a medical foot health checkup.
- Check the feet for new sores, redness, swelling or foul-smelling discharge regularly.
- Wash wounds with mild soap and warm water to avoid infection.
- Avoid walking barefoot or wearing shoes without socks when going outside.
- Avoid homemade chemical treatments for calluses, corns, and in-growing toenails.
- Use footwear that fits properly and does not rub the skin.
- If exposed to extreme cold for a prolonged period, keep an eye out for indications of frostbite.
- If the skin becomes pale, hard, cold, numb, or changes colour consult the doctor immediately.
Check for injuries if diabetic nerve damage causes skin changes, or numbness, - particularly in the foot.
- Keeping a healthy weight can avoid diabetes, vascular disease, and poor wound healing.
- Quit smoking
How to Diagnos of Gangrene?
Based on the physical examination, medical history and symptoms, the doctor may suspect that the patient has gangrene. The doctor may suggest additional diagnostic procedures to confirm the condition. The tests include:
- Blood t blood tests help to determine whether or not an infection is present.
- Fluid or tissue culture t A healthcare provider will collect a tiny sample from the affected area to identify which bacteria need to be treated.
- Imaging t X-rays, MRI scans, CT scans, and Doppler ultrasounds are examples of imaging tests.
- Surgical examina If the affected area is highly infected and cannot be treated only by medicines the doctor will decide for surgical intervention.
Vascular stu Vascular tests examine blood circulation to the affected area.
What are the Treatments for Gangrene?
If you develop gangrene symptoms, seek immediate medical care to minimise the effects. Gangrene treatment options include therapeutic and surgical procedures. If a bacterial infection causes gangrene, the doctor will prescribe antibiotics as tablets or as an injection. This is done to keep the infection from advancing into sepsis and septic shock.
Some nonsurgical therapies may be effective in treating skin gangrene without the need for surgery. The therapies are as follows:
- Hyperbaric oxygen This process involves lying in a pressurised chamber to increase the amount of inhaled oxygen. Higher oxygen levels in the blood can help eradicate germs and accelerate the healing process.
- Maggot is an old technique for removing dead tissue, often known as debridement. Modern maggot therapy uses specially grown, sterile larvae on the wound. These larvae eat dead tissue while avoiding the healthy tissues. If nonsurgical therapies are ineffective, surgical procedures could be used to help stop the spread of gangrene.
Gangrene surgical techniques include:
- Surgical debride A surgeon removes infected and dead tissue during surgical debridement. The goal is to eliminate as little healthy tissue as possible while removing all dead and diseased tissue.
- Vascular sur A surgeon may perform vascular surgery on the blood vessels if gangrene develops due to poor blood circulation. This surgery aims to increase circulation and preserve the tissue as healthy as possible.
- Amputa If the badly infected region is too large for debridement, such as the foot or fingers, it may need to be amputated. This is always the last option.
Do’s and Don’ts of Gangrene
Gangrene develops when tissue dies due to a lack of blood flow and oxygen. This infection is most commonly seen on the legs, but can also damage internal tissues. Gangrene must be treated as soon as possible to prevent other healthy tissues from getting infected.
Diabetics and blood vascular disease patients should frequently examine their hands and feet for gangrene signs. It is important to get treatment to avoid complications. Following the dos and don'ts listed below can help you manage your symptoms and avoid their negative impact on your health.
