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Understanding Gangrene: Symptoms, causes & treatment

Dr. SatabdiDec 20, 2023

The word Gangrene means ‘dead tissue’. The disease gets its name as tissues in a part of the body die in this condition. If left untreated, it can be life-threatening.

Thus, timely action is crucial. Read on to know more about Gangrene, including its types, symptoms, causes, and treatment methods.

Contents

What is Gangrene?
What are the different types of Gangrene?
What are the causes and risk factors of Gangrene?
What are the symptoms of Gangrene?
How is Gangrene diagnosed?
Treatment of Gangrene
How do I prevent Gangrene
Frequently asked questions

What is Gangrene?

Gangrene is a condition in which tissues in a part of our body die owing to the reduced blood supply to the area. It could also occur as a consequence of a serious bacterial infection. The toes, feet, fingers, and hands are the most commonly affected areas.

However, any part of the body can be affected by Gangrene. It typically starts in one small region and gradually spreads to adjacent sites as the condition progresses. The affected areas appear black or discoloured. In some cases, sloughing and a foul-smelling pus discharge also may be present. Without professional help, the infection can spread into the blood and eventually become fatal.

What are the different types of Gangrene?

There are three major types of Gangrene.

Dry Gangrene: The nutrition and oxygen required by various tissues of the body are supplied through the blood. Any blockage of a blood vessel can reduce or, in some cases, completely cut off blood circulation to the area supplied by it. Long-term disruptions in blood circulation eventually result in tissue death. This type of Gangrene is commonly seen among people with atherosclerosis (the blockage of blood vessels due to fat buildup along their walls.)
Wet Gangrene: This type of Gangrene occurs due to a bacterial infection. It is usually preceded by an injury, severe burn, or trauma. Patients with uncontrolled diabetes are highly prone to develop this condition due to accidental injuries to toes or limbs. In some cases, dry Gangrene can get infected and turn into wet Gangrene.
Gas Gangrene: This is a serious and life-threatening form of Gangrene that occurs due to bacteria multiplying in the deeper tissues such as muscles. These bacteria release toxins into the blood and emit gases that accumulate within the tissue layers. This is a very serious and life-threatening condition and needs emergency treatment.

In addition to these, there are the following types of Gangrene as well.

Internal Gangrene affects organs such as the appendix, gallbladder, and intestine. This occurs when the blood flow to an internal organ is cut off. Without treatment, internal Gangrene can become fatal.
Fournier’s Gangrene affects genital organs and the area around the genital region. It usually occurs as a consequence of an infection in the region. The sources of infection include urinary tract infections, piercings, and bladder infections. It is a life-threatening condition that can worsen quickly.
Meleney's Gangrene is a rare type of Gangrene that usually arises as a complication of surgery. It presents as extremely painful skin lesions that usually appear in the second week after surgery.

What are the causes and risk factors of Gangrene?

The following conditions can increase your risk of developing Gangrene

Uncontrolled diabetes
Conditions that cause narrowing and blockage of blood vessels such as atherosclerosis and peripheral artery disease
Severe injuries from accidents, burns, or frostbite
Obesity
Smoking
Poor immunity due to HIV infections, chemotherapy or radiation therapy for cancer, or certain medicines

What are the symptoms of Gangrene?

The symptoms of Gangrene vary based on the type and the underlying cause.

Dry Gangrene

The features of dry Gangrene are as follows.

The involved area is cold and numb.
The colour of the skin over the area changes to red, brown, and eventually to black.
The body part becomes shrivelled, and dry and may eventually fall off.

Wet Gangrene

The symptoms of wet Gangrene include the following.

Redness, soreness, and swelling of the wound.
Red, purplish or black discolouration of the skin.
Numbness or severe pain in the affected area.
Blisters and foul-smelling pus discharge from the area.
Thin, hairless, and shiny skin.

Gas Gangrene

Gas Gangrene is usually accompanied by the following.

Initially, normal skin gradually changes colour to pale, grey, and purple.
Shiny skin.
Cracking sound on pressing the surface.

How is Gangrene diagnosed?

The diagnosis of Gangrene is based on the history, a thorough clinical examination, and tests.

Medical history: Your doctor will inquire about your health status, history of long-standing diseases, the medicines you take for them, and any recent injury that could have contributed to the development of Gangrene.
Physical examination: Your doctor will examine the affected area for signs of Gangrene, such as discolouration of the skin and pus discharge.
Tests: Different tests are performed to assess the underlying cause of the Gangrene and for evaluation of its extent.
- Blood tests to evaluate your health status and to detect the presence of infection.
- Bacterial culture to identify the type of bacteria.
- Imaging studies such as X-rays, CT and MRI to confirm the diagnosis and to assess the spread of the infection.
- Tests to assess the blood flow to the area.

Treatment of Gangrene

There are multiple treatment options for the management of Gangrene. The treatment approaches are mainly aimed at removing the dead tissue, preventing and treating the infection, and resolving the condition that leads to Gangrene. These options include the following.

Medications: Medicines are given intravenously or taken by mouth to treat the infection and relieve the pain.
Surgery: The surgical technique is determined based on the type of Gangrene and its severity. In some cases, more than one surgery may be required.
- The dead and damaged tissue is removed through a process called debridement. This is done to stop the spread of infection.
- In some severe cases, your doctor may surgically remove a whole infected body part such as a toe, finger, arm, or leg. This is called amputation.
- You may additionally require vascular surgery to repair damaged or diseased blood vessels to restore the blood flow to the affected area.
- If a larger area of tissue is removed, your doctor may reconstruct the area with skin taken from another healthy site.
Hyperbaric oxygen therapy: During the procedure, you may sit or lie down in a specialised chamber filled with oxygen at high pressure. As a result, the oxygen in your bloodstream increases. This helps in slowing down the growth of bacteria and fastens your healing.

How do I prevent Gangrene

You can prevent Gangrene by controlling your risk factors.

Manage diabetes and frequently monitor for any injury on toes, feet, legs, and hands.
Maintain a healthy lifestyle which includes well-balanced food and regular exercise.
Monitor your wounds and seek medical help if you notice any evidence of infection.
Quit smoking.
If you have diabetes or vascular diseases, be extra cautious to prevent injuries.
Avoid the possibility of burns or frostbite.

Frequently asked questions

Here is a list of certain frequently asked questions on Gangrene.

Who is at the most risk of having Gangrene?

People with diabetes and those with diseases that cause narrowing of blood vessels such as peripheral artery disease and Raynaud's disease are at the highest risk of being affected by Gangrene. In case you fall into the high-risk category, ensure that you monitor for any injuries and consult your doctor in case there is a delay in healing.

Is it possible to heal and revive the tissues damaged by Gangrene?

The tissues that are dead due to Gangrene can not be revived. However, with proper medical treatment, you will be able to arrest the progress of the disease and heal the wound.

What is the link between Gangrene and diabetes?

The high blood sugar level in people with diabetes damages their nerves. This could result in loss of sensation on the foot. Hence diabetic patients are prone to injure their feet without realising it. Hence they are more likely to develop Gangrene.

What will happen if I leave Gangrene untreated?

If left untreated, Gangrene can give rise to the spread of infection in the blood called sepsis. It is a life-threatening condition characterised by low blood pressure, fever, increased heart rate, shortness of breath, confusion, and organ failure.

How does Gangrene spread?

Gangrene occurs when the blood supply to an area is cut off. If the blockage of circulation is not removed, there is greater tissue damage and swelling of the region. Unless the dead tissue is removed and blood circulation is restored, the Gangrene continues to spread to adjacent areas. If the infection extends into the blood, it leads to sepsis.

References

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on several secondary sources on the internet. Please consult a doctor before making any health-related decisions.