Gangrene is the death of body tissue due to a severe bacterial infection or a lack of blood flow. Gangrene commonly affects the fingers, toes, and limbs. Apart from these extremities, it can also affect your internal organs and muscles.
Underlying medical conditions such as diabetes or atherosclerosis (hardened arteries), that can harm your blood vessels and affect blood flow can increase your chances of developing gangrene.
Symptoms of Gangrene
When gangrene affects the skin, signs and symptoms may include:
- Skin discoloration
- Sudden, severe pain followed by a feeling of numbness
- Formation of blisters filled with fluid on the skin
- A thin, shiny skin without hair
- A clear line between healthy and damaged skin
- A foul-smelling discharge leaking from a sore
- Skin that feels cool or cold to the touch
If you have a type of gangrene that affects tissues beneath the surface of your skin, such as gas gangrene or internal gangrene, symptoms may include:
- Swollen tissue which is very painful
- Low-grade fever
Septic shock can occur if a bacterial infection that originated in the gangrenous tissue spreads throughout your body. Signs and symptoms of septic shock include:
- Rapid heart rate
- Low blood pressure
- Fever, with temperature lower than the normal 96.8 F (36 C)
- Shortness of breath
Causes of Gangrene
Gangrene may be caused by:
- Lack of blood supply:Your blood provides oxygen, nutrients to feed your cells. Your cells cannot survive without a proper blood supply.
- Infection:If a bacterial infection is left untreated for long, it take over and cause your tissue to die, leading to gangrene.
- Trauma:Traumatic wounds like gunshot wounds, car crashes, can cause bacteria to attack tissues deep within the body. When such tissues are infected, leading to gangrene.
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Types of Gangrene
- Dry gangrene: This is common in people who have arterial blood vessel disease. It is characterized by dry and shriveled skin ranging in color from brown to purplish blue or black. Dry gangrene may develop slowly.
- Wet gangrene: This involves a bacterial infection in the affected tissue. It may develop after a frostbite, severe burn, or injury.
- Gas gangrene: Gas gangrene affects deep muscle tissue. Your skin may appear normal initially. Your skin may become pale and then evolve to a gray or purplish red color as the condition progresses. A bubbly appearance to your skin may become apparent, and the affected skin may make a crackling sound when you press on it because of the gas within the tissue.
- Internal gangrene: This type of gangrene affects one or more of your organs, such as your intestines, gallbladder or appendix. It occurs when blood flow to an internal organ is obstructed. Internal gangrene can be deadly if left untreated.
- Fournier’s gangrene: This type affects the genital organs. Men are mostly affected, but women can develop it too. Fournier’s gangrene usually arises due to an infection in the genital area or urinary tract and causes genital pain, tenderness, redness and swelling.
Several factors increase your risk of developing gangrene, such as:
- Diabetes:The body of a diabetic cannot produce enough of the hormone insulin, or is resistant to the effects of insulin. High blood sugar levels can eventually damage blood vessels, interrupting blood flow to a part of your body.
- Blood vessel disease: Atherosclerosis and blood clots also can cause blockage of blood flow to an area of your body.
- Severe injury or surgery:Your risk of developing gangrene would increase if you have any trauma to your skin, an injury or frostbite, especially if you have an underlying condition that affects blood flow to the affected area.
- Smoking:The risk of smokers developing gangrene is higher.
- Obesity often accompanies diabetes and vascular disease, but the stress of extra weight alone can also compress arteries, leading to reduced blood flow.
- Those with human immunodeficiency virus (HIV) or people undergoing chemotherapy or radiation therapy are also at higher risk since their body cannot fight off infections.
In some cases, the amount of tissue death is so widespread that a body part may need to be amputated. Gangrene that is infected with bacteria can spread quickly to other organs and may be deadly if left untreated.
Tips to help you reduce your risk of developing gangrene includes:
- Care for your diabetes:Diabetic persons should always examine their hands and feet daily for cuts, sores and signs of infection, such as redness, swelling or drainage. Your doctor should check your hands and feet at least once a year, and try to control your blood sugar levels.
- Lose weight:Excess weight can increase your chances of developing diabetes and can mount pressure on your arteries, tightening blood flow and putting you at risk of infection and slowing down wound.
- Avoid tobacco:Excess use of tobacco products can harm your blood vessels.
- Help prevent infections.Wash any open wounds with a mild soap and water and try to keep them clean and dry until they heal.
When to see a doctor
Gangrene requires immediate medical condition. Call your doctor right away if you have:
- Persistent fever
- Persistent pain in any part of your body
- Skin changes that won’t heal
- Skin that is hard, numb, cold, and pale
- A foul-smelling discharge leaking from a sore
- Sudden pain at the site of a recent surgery or trauma
Tests used to help make a diagnosis of gangrene include:
- Blood tests.Blood test that indicates high white blood cell count is the sign of an infection.
- Imaging tests.An X-ray, a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan can be used to view internal body internal organs, blood vessels or bones, and assess the extent to which gangrene has spread.
- Surgery may be performed
- Fluid or tissue culture.A culture of the fluid from a blister on your skin may be examined for the bacterium Clostridium perfringens, which is commonly responsible for gas gangrene.
Surgery may be performed to remove dead tissue. Tissue that has been damaged by gangrene can’t be saved, but steps can be taken to prevent gangrene from progressing.
A dead tissue may be removed by performing surgery. Your doctor may repair damaged or diseased blood vessels in order to increase blood flow to the affected area. Occasionally, more than one surgery may be required to remove all dead or infected tissue. Your doctor may use a skin graft to fix a damage to your skin if reconstructive surgery is needed.
Antibiotics may be administered intravenously or orally to treat gangrene that has become infected. If you have to have surgery to remove dead tissue, your doctor will probably prescribe certain antibiotics until no further surgery is needed and your infection is cleared.
Hyperbaric oxygen therapy
In this therapy, the patient will be placed in a special chamber, which usually consists of a padded table that slides into a clear plastic tube. The chamber is pressurized with pure oxygen, and the pressure inside the chamber will slowly rise to about 2.5 times normal atmospheric pressure. Hyperbaric oxygen therapy for gas gangrene generally lasts about 90 minutes. You may need two to three treatments daily.
The concept of this therapy is that under increased pressure and increased oxygen content, your blood can carry greater amounts of oxygen. Blood rich in oxygen slows the growth of bacteria that thrive in the absence of oxygen and helps infected wounds heal more easily.
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