Gangrene

Description

Gangrene is the death of body tissue due to a lack of blood flow or a serious bacterial infection. Gangrene commonly affects the arms and legs, including your toes, fingers and toes. It can also occur in the muscles and the organs within the body, such as the gallbladder.

A condition that can damage your blood vessels and affect blood flow, such as diabetes or hardening of the arteries (atherosclerosis), increases the risk of gangrene.

Treatments for gangrene may include antibiotics, oxygen therapy, and surgery to restore blood flow and to remove the dead tissue. The previous gangrene is identified and treated, the better the chances for recovery.

Symptoms

When the gangrene affects the skin, the signs and symptoms may include:

  • Changes in the color of the skin — ranging from light gray to blue, purple, black, bronze, or red
  • Swelling
  • Blisters
  • A sudden, severe pain followed by a feeling of numbness
  • A foul-smelling leak of a pain
  • Thin, shiny skin, or the skin without hair
  • The skin feels cool or cold to the touch

If the gangrene affects the tissues beneath the surface of the skin, such as gas gangrene or internal gangrene, and you may also have a low grade fever and general malaise.

If the germs that caused the gangrene spread through the body, a condition called septic shock can occur. The signs and symptoms of septic shock are:

  • Low blood pressure
  • Fever, though some people may have a body temperature below 98.6 F (37 ° C)
  • Rapid heart rate
  • Stunning
  • Shortness of breath
  • The confusion

When to see a doctor

Gangrene is a serious condition that needs emergency treatment. Call your health care provider right away if you have persistent, unexplained pain in any area of your body, along with one or more of the following signs and symptoms:

  • Persistent fever
  • Skin changes including discoloration, warmth, swelling, blisters, or lesions — that does not go away
  • A foul-smelling leak of a pain
  • Sudden pain at the site of a recent surgery or trauma
  • Pale skin, hard, cold and numb

Causes

Cause of the gangrene include:

  • The lack of blood supply. The blood provides oxygen and nutrients to the body. It also provides the immune system with antibodies to fight infections. Without a good blood supply, cells can no longer survive, and the tissue dies.
  • Infection. Treat the bacterial infection can cause gangrene.
  • The traumatic injury. Gunshot wounds, or crushing injuries from auto accidents can cause open wounds that allow the bacteria in the body. If the bacteria that infect the tissues and remain untreated, gangrene can occur.

Types of gangrene

  • Gangrene dry. This type of gangrene involves dry and wrinkled skin that looks brown to purple, blue or black. Gangrene dry may develop slowly. It occurs more commonly in people who have diabetes or disease of the blood vessels, such as atherosclerosis.
  • Gangrene wet.The gangrene is known as wet if the bacteria have infected the tissue. Swelling, blisters and a wet appearance are common characteristics of gangrene wet. Gangrene wet, it can develop after a severe burn, burn, or injury. It often occurs in people with diabetes, without knowing it, injuring a toe or foot. Gangrene wet it must be treated immediately, because it spreads quickly and can be deadly.
  • Gas gangrene.Gangrene usually affects the deep muscles of the tissue. The surface of the skin may appear normal at first. As the condition worsens, the skin may become pale, and then turn other colors such as gray or purplish red. The skin may look bubbly. You can make a crackling sound when you press on it, because the gas in the tissue. Gas gangrene is most often caused by a bacteria called Clostridium perfringens. Bacteria gather in an injury or surgical wound that has no blood supply. The bacterial infection produces toxins that release gas and cause tissue death. As gangrene wet gangrene is a life-threatening condition.
  • Internal gangrene. Internal gangrene affects one or more of the organs, such as intestines, gallbladder, or appendix. Occurs when blood flow to an internal organ is locked. For example, it can occur if the intestines to bulge through a weakened area of muscle mass in the abdominal wall (hernia) and crooked. Left untreated, internal gangrene can be deadly.
  • Fournier's gangrene. This type of gangrene involves the genitals. It usually affects men, but women also can access to it. An infection in the genital area or in the urinary tract causes this type of gangrene.
  • The gangrene of Meleney. This is a rare type of gangrene. It is usually a complication of the surgery. Painful skin lesions that usually occur one to two weeks after surgery. Another name for this disease is progressive bacterial gangrene, synergistic.

Gangrene wet. The gangrene is known as wet if the bacteria have infected the tissue. Swelling, blisters and a wet appearance are common characteristics of gangrene wet.

Gangrene wet, it can develop after a severe burn, burn, or injury. It often occurs in people with diabetes, without knowing it, injuring a toe or foot. Gangrene wet it must be treated immediately, because it spreads quickly and can be deadly.

Gas gangrene. Gangrene usually affects the deep muscles of the tissue. The surface of the skin may appear normal at first.

As the condition worsens, the skin may become pale, and then turn other colors such as gray or purplish red. The skin may look bubbly. You can make a crackling sound when you press on it, because the gas in the tissue.

Gas gangrene is most often caused by a bacteria called Clostridium perfringens. Bacteria gather in an injury or surgical wound that has no blood supply. The bacterial infection produces toxins that release gas and cause tissue death. As gangrene wet gangrene is a life-threatening condition.

Risk factors

Things that may increase the risk of gangrene include:

  • Diabetes. High levels of sugar in the blood can damage the blood vessels. Blood vessel damage can slow or block the flow of blood to a part of the body.
  • Disease of the blood vessels. Hardening and narrowing of the arteries (atherosclerosis) and blood clots can block the flow of blood to an area of the body.
  • Serious injury or surgery. Any process that causes trauma to the skin and underlying tissue, including the freezing, increases the risk of gangrene. The risk is higher if you have an underlying condition that affects the flow of blood to the injured area.
  • The habit of smoking. People who smoke have a higher risk of gangrene.
  • Obesity. The excess of weight you can push on the arteries, slowing the flow of blood and increase the risk of infection and poor wound healing.
  • The immunosuppression. Chemotherapy, radiation, and certain infections, such as human immunodeficiency virus (HIV), can affect the body's ability to fight infections.
  • Injections. Rarely, injection drug use have been linked to infection with the bacteria that cause gangrene.
  • Complications of coronavirus disease 2019 (COVID-19). There have been some reports of people getting dry gangrene in the fingers and toes of the feet after COVID-19 -related problems of clotting (coagulopathy). More research is needed to confirm this link.

Complications

Gangrene can lead to serious complications if not treated immediately. The bacteria can quickly spread to other tissues and organs. You may need to have a body part removed (amputated) to save his life.

The removal of the infected tissue can lead to scarring or the need for reconstructive surgery.

Prevention

Here are some ways you can help reduce the risk of developing gangrene:

  • Control diabetes. If you have diabetes, it is important to control the levels of sugar in the blood. Also be sure to examine your hands and feet daily for cuts, sores and signs of infection, such as redness, swelling, or drainage. Ask your health care provider to check your hands and feet at least once a year.
  • To lose weight. Extra pounds increase the risk of diabetes. The weight also puts pressure on the arteries, slowing the flow of blood. Decreased flow of blood increases the risk of infection, and causes slow healing of wounds.
  • Do not smoke or use tobacco. Long-term tobacco damages the blood vessels.
  • Wash your hands. Practice good hygiene. Wash the wounds with a mild soap and water. Keep your hands clean and dry until they are healed.
  • Check the freeze. Freezing reduces the flow of blood in the affected part of the body. If you have pale skin, hard, cold and numb after being in cold temperatures, call your care provider.

Gangrene

Diagnosis

The tests are used to diagnose the gangrene include:

  • Blood tests. A high white blood cell count is often a sign of infection. Other blood tests may be done to check for the presence of certain bacteria and other germs.
  • Fluid or tissue culture. You can perform tests to detect the presence of bacteria in the sample of fluid from a blister on the skin. A sample of tissue can be examined under a microscope for signs of cell death.
  • Imaging tests. X-rays, computed tomography (CT) and magnetic resonance imaging (MRI) can show the organs, blood vessels and bones. These tests can help to show to what extent the gangrene has spread through the body.
  • Surgery. The surgery can be performed to obtain a better appearance at the inside of the body and learn the amount of infected tissue.

Treatment

The tissue that has been damaged by the gangrene can't be saved. But treatment is available to help prevent the gangrene from getting worse. The faster you get treatment, the better your chances of recovery.

The treatment of gangrene may include one or more of the following:

  • Medicine
  • Surgery
  • Hyperbaric oxygen therapy

Drugs

Medications to treat bacterial infections (antibiotics) are administered intravenously (IV) or taken by mouth.

Pain medication may be given to relieve the discomfort.

Surgery or other procedures

Depending on the type of gangrene and its severity, more than one surgery may be needed. Surgery for gangrene include:

  • The debridement. This type of surgery is done to remove the infected tissue and stop the infection from spreading.
  • Vascular Surgery. You can perform a surgery to repair any damage or diseased blood vessels to restore blood flow to the infected area.
  • The amputation. In severe cases of gangrene, the infected body part — such as a toe, finger, arm or leg — you may need to be surgically removed (amputated). Later can be fitted with an artificial limb (prosthesis).
  • A skin graft (reconstructive surgery). Sometimes, surgery is needed to repair the damaged skin or to improve the appearance of gangrene associated with scars. This type of surgery can be performed using a skin graft. During a skin graft, the surgeon removes the healthy skin from another part of the body and placed on the affected area. A skin graft can be done only if there is a sufficient supply of blood to the area.

Hyperbaric oxygen therapy

Hyperbaric oxygen therapy is performed inside a chamber pressurized with pure oxygen. You generally lie on a padded table that slides into a clear plastic tube. The pressure inside the chamber is slowly increased to about 2.5 times the regular atmospheric pressure.

Hyperbaric oxygen therapy helps the blood to carry more oxygen. The oxygen-rich blood reduces the growth of bacteria that live in the tissue of the lack of oxygen. It also helps to heal wounds infected with more ease.

A hyperbaric oxygen therapy session for gangrene usually lasts around 90 minutes. Two to three treatments a day may be necessary until the infection goes away.

Preparing for your appointment

Call your health care provider right away if you have symptoms of gangrene. Depending on the severity of your symptoms, you may be told to go to the emergency room or call 911 or the local emergency number for medical help.

If you have time before you leave the house or on the way to the hospital, use the information below to prepare for your visit.

What you can do

  • Write down any symptoms you have and how long you have taken Note as many details as possible about when the symptoms appeared for the first time. Include how they can be worse or spread over time.
  • Note any trauma or injury to the skin, such as cuts, bites, injections, surgery or possible freezing. If you have recently used drugs by injection, tell the health care provider.
  • List important medical information, including any other terms and conditions that you have.
  • List of all medications, vitamins or supplements you are taking. Include your dose.
  • Have a family member or friend. Gangrene is a medical emergency. Take someone with you to help you to remember all information that you receive. You also want someone who can stay with you if you need treatment immediately.
  • Write questions to ask their health care provider.

By gangrene, some basic questions to ask your health care provider include:

  • What is the most likely cause of the symptoms or condition?
  • What kinds of tests do I need?
  • Do I have to stay in the hospital?
  • What treatments do I need?
  • How soon treatment work?
  • I'm going to have a full recovery? If so, how much recovery time?
  • Am I at risk of long-term complications?

Do not hesitate to ask your doctor any additional questions.

What to expect from your doctor

Your health-care provider, it is likely that a number of questions to help determine the diagnosis and the treatment. You may ask:

  • What are your symptoms?
  • When did the symptoms begin?
  • How painful is the affected area?
  • The symptoms seem to be spreading or getting worse?
  • Have you had any recent injury or trauma to the skin, like cuts, wounds, stings or surgery?
  • Have you been in very cold temperatures, which makes your skin change color or turn numb?
  • Does the use of injectable drugs, including illegal drugs?
  • Have you been diagnosed with any other medical condition?
  • What medications are you taking or have recently taken, including prescription, over-the-counter drugs, herbs and supplements?
Symptoms and treatment of Gangrene