What is Gangrene?

    Gangrene is the term used to describe when part of your body tissue dies, usually because it is not getting enough blood from your circulatory system.

    Gangrene usually affects your extremities—the areas farthest from your heart—such as your toes and fingers. However, it can affect other parts of our body as well. Gangrene can even affect your internal organs.

    The condition typically starts in a specific body part, such as a leg, hand, or internal organ. If left untreated, it can spread through your body and cause you to go into shock. Shock is a condition marked by a variety of symptoms including low blood pressure. Shock can be life threatening and is considered a medical emergency.

    Gangrene is a medical emergency that could lead to amputations and could even kill you. The sooner you recognize and treat the condition, the better your outlook.

    Types of Gangrene

    Dry Gangrene

    All of your body organs (such as your liver, heart, muscles) need oxygen to function properly and survive. The oxygen is carried to different parts of your body by your blood. If one of your body parts loses enough oxygen, it could start to deteriorate and die, leading to the condition called dry gangrene.

    Wet Gangrene

    Wet gangrene happens when your body tissues become infected with some type of bacteria. The tissues react to the presence of the bacteria by growing moist and breaking down. This process causes the death of your tissues.

    Gas Gangrene

    Gas gangrene is caused by bacteria called Clostridia, which cause gas bubbles and toxins to develop inside the affected area. The resulting gases cause tissue death. This type of gangrene is rare in the United States.

    Who Is At Risk for Developing Gangrene?

    You are more likely to develop gangrene if you have a history of certain medical conditions, including:

    • arteriosclerosis (hardening of the arteries) in your legs or arms
    • Raynaud’s disease
    • diabetes
    • blood clots
    • appendicitis
    • hernia

    Some other physical events could increase your risk of gangrene. You may be more likely to develop this condition if you:

    • have lowered immunity because of a medical condition or cancer treatment
    • have recently had surgery
    • have suffered a head injury, an animal bite, a serious burn, or severe frostbite
    • have been hurt in a traumatic way that includes the crushing of body tissues (Carson-DeWitt, 2012)
    • have had an injection of promethazine hydrochloride that led to tissue damage (FDA)

    Smoking, drinking alcohol, and intravenous drug use may also add to your risk of developing gangrene.

    Recognizing the Signs of Gangrene

    External Gangrene

    Sometimes the first sign of dry gangrene is a reddish line that develops around the affected tissue. This line may later turn black.

    Here are some other signs that might indicate you have gangrene:

    • You have a wound that is red, sore, or swollen.
    • You have a wound that is filled with pus or gives off a bad smell.
    • A specific area of your body feels cold.
    • You have lack of any sensation in a certain area.
    • There are sores that keep coming back in the same place on your body.
    • Part of your skin has turned an unusual color, such as greenish-black, red, blue, or bronze.

    Internal Gangrene

    It is also possible to experience internal gangrene, which affects your inner tissues or organs. In this case, you may not have any symptoms on your skin or limbs. However, you may have pain or an unexplained fever that lasts a long time or low blood pressure. You may also feel confused or seem that way to others.

    How Is Gangrene Diagnosed?

    Your doctor may suspect that you have gangrene based on your medical history and symptoms. He or she may also use a combination of additional diagnostic methods to determine your condition.

    Lab Analysis of Tissue or Fluid Samples

    A scraping of tissue from your affected body part may be examined with a microscope to look for dead cells. If you have blisters, a sample of the fluid from a blister can be checked for the bacteria that cause gas gangrene.

    Blood Tests

    If your white blood count is higher than usual, this could indicate that you have a gangrenous infection.

    Medical Imaging

    Some kinds of imaging are helpful in diagnosing the spread of gangrene in your internal tissues. These tests could include X-rays, MRI scans, or CT scans.

    If doctors suspect that your gangrene is related to a circulatory problem, an arteriogram might be performed. This test uses X-rays to monitor the flow of a special dye through your arteries, showing whether any arteries are blocked.

    Gangrene Treatment

    Antibiotics

    If bacteria are present, your doctor may prescribe antibiotics. These are typically given intravenously, or through a needle directly into the blood stream.

    Vascular Surgery

    For people with poor circulation that results in gangrene, vascular surgery (surgery on the arteries or veins) may be recommended in order to improve the flow of blood through the veins to body tissues.

    Hyperbaric Oxygen Chamber

    Cases of gas gangrene are sometimes treated by placing the affected person in a special oxygen-rich environment. This process slows the growth of bacteria, allowing the skin to begin healing.

    Tissue Debridement

    In serious gangrene cases, the dead tissue or body part may need to be removed. This process is called debridement. Debridement can be done with surgery tools or with chemicals. The goal with this type of surgery is to remove the affected areas so the infection can no longer spread.

    One alternative form of debridement, known as maggot debridement, uses fly larvae to eat away bacteria and dead tissue (UniversityofRochester). Though rare, this practice can still be used by physicians in the United States and abroad.

    If doctors are able to restore oxygen to the damaged tissue, a skin graft can be used to repair the affected area. This procedure uses a piece of your healthy skin from elsewhere on the body to cover the damaged area.

    Amputation

    For severe cases, amputation of a limb, finger, or toe could be necessary to save your life. People who must have part of an arm or leg amputated due to gangrene are usually fitted with a prosthesis, or artificial limb, to replace the missing body part.

    What Is the Long-Term Outlook for a Patient With Gangrene?

    Gangrene can sometimes be treated without serious complications, especially if it is caught early.

    However, it can lead to amputation in some serious cases, particularly if it is not treated quickly.

    Gangrene can even be fatal for some individuals, depending on the interaction of several factors. This is rare, but can occur if you have other serious medical issues that complicate your treatment, the gangrenous area covers a large area of your body, and if treatment is not provided quickly enough.

    How to Prevent Gangrene

    To keep tissues from dying, gangrene must be treated early, so that the damage can be reversed. If you are diabetic or have a blood vessel disease, you can examine your feet and hands regularly to check for symptoms of gangrene. Watch for:

    • any swelling, discharge, or redness that may indicate infection
    • a wound does not seem to get better
    • a change in the color of your skin

    Taking antibiotics before or after having surgery, under the care of your doctor may help you to prevent the development of gangrenous infections.