Gangrene is tissue death caused by a lack of blood supply or a significant bacterial infection. Gangrene typically affects the arms and legs, as well as the toes and fingers. It can also arise in the muscles and internal organs such as the gallbladder.
Diabetes and hardened arteries (atherosclerosis), both of which can damage blood vessels and impair blood flow, increase the risk of gangrene.
Antibiotics, oxygen treatment, and surgery to restore blood flow and remove dead tissue may be used to treat gangrene. The sooner gangrene is diagnosed and treated, the higher the prospects of recovery.
WHAT ARE THE TYPES OF GANGRENE?
- Dry gangrene: This kind of gangrene causes dry, shriveled skin that ranges from brown to purplish blue to black. Dry gangrene can develop gradually. Diabetes and blood vessel disease, such as atherosclerosis, are the most prevalent causes.
- Wet gangrene: If bacteria have infiltrated the tissue, gangrene is referred to as moist. Wet gangrene is characterized by swelling, blistering, and a wet look.
Wet gangrene can form as a result of a severe burn, frostbite, or injury. It frequently develops in diabetics who inadvertently damage a toe or foot. Wet gangrene must be treated right once since it spreads swiftly and can be fatal.
- Internal gangrene: Internal gangrene is a condition that affects one or more organs, such as the intestines, gallbladder, or appendix. It happens when blood supply to an inside organ is cut off. It might happen, for example, if the intestines protrude through a weaker patch of muscle in the stomach (hernia) and get twisted. Internal gangrene can be fatal if left untreated.
- Fournier's gangrene: The vaginal organs are affected by this kind of gangrene. It primarily affects men, although it can also impact women. This kind of gangrene is caused by a genital or urinary tract infection.
- Meleney's gangrene: This is an uncommon kind of gangrene. It is frequently a surgical complication. Painful skin sores are common one to two weeks following surgery. This illness is also known as progressive bacterial synergistic gangrene.
- Gas gangrene: Deep muscular tissue is commonly affected by gas gangrene. At first glance, the surface of your skin may appear normal.
As the illness progresses, the skin may become pale and eventually become gray or purplish red. The skin may seem bubbly. Because of the gas within the tissue, pressing on it may produce a cracking sound.
Clostridium perfringens bacteria are the most prevalent cause of gas gangrene. Bacteria congregate in a bloodless injury or surgical site. Toxins produced by the bacterial infection promote gas production and tissue death. Gas gangrene, like wet gangrene, is a potentially fatal disease.
WHAT ARE THE SYMPTOMS OF GANGRENE?
When gangrene infects the skin, the following signs and symptoms may occur:
- Skin color changes ranging from pale gray to blue, purple, black, bronze, or red
- Swelling
- Blisters
- Pain that comes on suddenly, followed by numbness
- A foul-smelling discharge from a wound
- Skin that is thin, glossy, or hairless
- Skin that is cool to the touch or chilly to the touch
If you have gangrene that affects the tissues beneath the surface of your skin, such as gas gangrene or internal gangrene, you may have a low-grade temperature and feel generally ill.
Septic shock can develop if the microorganisms that caused the gangrene spread throughout the body. The following are signs and symptoms of septic shock:
- Low blood pressure
- Fever, while some persons may have a lower body temperature than 98.6 F. (37 C)
- High heart rate
- Lightheadedness
- Breathing difficulty
- Confusion
WHAT ARE THE CAUSES OF GANGRENE?
Among the causes of gangrene are:
- There is a blood supply shortage: The blood transports oxygen and nutrients throughout the body. It also delivers antibodies to the immune system to help it battle infections. Cells cannot survive in the absence of adequate blood flow, and tissue dies.
- Infection: Gangrene can result from an untreated bacterial infection.
- Traumatic injury: Gunshot wounds or crushing injuries from vehicle accidents can result in open wounds that allow microorganisms to enter the body. Gangrene can arise if germs invade tissues and go untreated.
WHAT ARE THE RISK FACTORS FOR GANGRENE?
The following factors can raise the risk of gangrene:
- Diabetes: High blood sugar levels might damage blood vessels over time. Damage to blood vessels can impede or stop blood flow to a specific area of the body.
- Serious injury or surgery: The risk of gangrene is increased by any process that produces harm to the skin and underlying tissue, including frostbite. If you have an underlying ailment that impairs blood flow to the damaged location, the danger is increased.
- Smoking: People who smoke are more likely to get gangrene.
- Obesity: Extra weight can put strain on arteries, decreasing blood flow and increasing the likelihood of infection and poor wound healing.
- Blood vessel disease: Blood clots and hardened and restricted arteries (atherosclerosis) can both limit blood flow to a specific location of the body.
- Immunosuppression: Chemotherapy, radiation, and some diseases, such as the human immunodeficiency virus (HIV), can all have an impact on the body's capacity to fight infections.
- Injections: In rare cases, injectable medications have been related to gangrene-causing bacteria infection.
- COVID-19 complications: There have been many cases of persons developing dry gangrene in their fingers and toes as a result of COVID-19-related blood coagulation issues (coagulopathy). More study is required to validate this connection.
WHAT ARE THE COMPLICATIONS OF GANGRENE?
If gangrene is not treated promptly, it can lead to significant problems. Bacteria can swiftly spread to different tissues and organs. To preserve your life, you may need to have a bodily component removed (amputated).
Scarring or the necessity for reconstructive surgery may result from the removal of infected tissue.
HOW IS GANGRENE DIAGNOSED?
The following tests are used to help detect gangrene:
- Blood tests: A high white blood cell count is frequently indicative of infection. Other blood tests can be performed to detect the presence of certain bacteria and germs.
- Imaging tests: Organs, blood arteries, and bones can be seen using X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans. These tests can help determine how far gangrene has gone in the body.
- Surgery: Surgery may be performed to have a clearer view of the inside of the body and determine how much tissue is diseased.
- Fluid or tissue culture: Bacteria can be detected using tests on fluid samples taken from a skin blister. A tissue sample can be inspected under a microscope to look for evidence of cell death.
WHAT ARE THE TREATMENTS FOR GANGRENE?
Damaged tissue from gangrene cannot be saved. However, medication is available to help prevent gangrene from worsening. The sooner you receive therapy, the greater your chances of recovery.
Gangrene treatment may comprise one or more of the following:
- Medication
- Surgery
- Hyperbaric oxygen treatment
Medications
Antibiotics are used intravenously or orally to treat bacterial infections.
To alleviate discomfort, pain medicines may be used.
Surgery or other medical treatments
Depending on the kind of gangrene and its severity, many surgeries may be required. Gangrene surgery involves the following procedures:
- Debridement: This operation is used to remove contaminated tissue and prevent the illness from spreading.
- Vascular surgery: To restore blood flow to the affected region, surgery may be performed to repair any damaged or diseased blood vessels.
- Amputation: In extreme cases of gangrene, the diseased body part may need to be surgically removed, such as a toe, finger, arm, or leg (amputated). You may be equipped with an artificial limb in the future (prosthesis).
- Skin grafting (reconstructive surgery): Surgery is sometimes required to heal damaged skin or to enhance the look of gangrene scars. A skin transplant may be used in such operation. The surgeon takes healthy skin from another region of the body and puts it over the afflicted area during a skin transplant. A skin graft can only be performed if the location has enough blood flow.
Hyperbaric oxygen treatment
Hyperbaric oxygen treatment is performed in a chamber filled with pure oxygen. Typically, you will be lying on a cushioned surface that glides into a transparent plastic tube. The pressure within the chamber will gradually grow to approximately 2.5 times normal air pressure.
Hyperbaric oxygen treatment increases the amount of oxygen carried by the blood. Bacteria that thrive in tissue that lacks oxygen are slowed by oxygen-rich blood. It also aids in the healing of infected wounds.
A 90-minute hyperbaric oxygen therapy session for gangrene is typical. Two to three doses per day may be required until the illness is eradicated.
HOW CAN GANGRENE BE PREVENTED?
Here are a few things you can do to lower your chances of getting gangrene:
- Manage diabetes: Controlling your blood sugar levels is critical if you have diabetes. Also, check your hands and feet on a regular basis for wounds, sores, and indications of infection, such as redness, swelling, or discharge. Request that your doctor examine your hands and feet at least once a year.
- Reduce your weight: Obesity increases the risk of diabetes. The weight also puts strain on the arteries, causing blood flow to slow. Reduced blood flow raises the risk of infection and slows wound healing.
- Do not use tobacco or smoke: Tobacco use over time harms blood vessels.
- Wash your hands: Maintain good hygiene. Wash any open wounds with warm water and mild soap. Maintain clean and dry hands until they recover.
- Check for frostbite: Frostbite lowers blood flow to the afflicted part of the body. Call your doctor if your skin becomes pale, hard, cold, or numb after being exposed to cold temperatures.