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by Carson-DeWitt R

Gangrene

(Dry Gangrene; Gas Gangrene; Organ or Tissue Death; Wet Gangrene)

Definition

Gangrene is the progressive death of body tissue resulting from a lack of blood supply. When the blood supply is cut off, the tissue does not get enough oxygen and begins to die.
Gangrene can be internal or external. The two most common types of gangrene are:
  • Dry gangrene—Lack of blood supply causes the tissue to die.
  • Wet gangrene—Usually occurs when the tissue is infected with bacteria from an injury. The tissue becomes moist and breaks down.
A rarer wet type, called gas gangrene, develops from specific bacteria deep inside the body. Gas gangrene can be a result of surgery or trauma.

Causes

Gangrene is caused by infection or a reduced blood supply to tissues.

Risk Factors

Factors that may increase your chance of developing gangrene include:

Symptoms

External gangrene may cause:
  • Color changes, ranging from white, to red, to black
  • Shiny appearance to skin
  • Foul-smelling, frothy, clear, or watery discharge
  • Sloughing off of skin
  • Severe pain followed by loss of feeling in the affected area
Internal gangrene may cause:
  • Fever and chills
  • Confusion
  • Nausea and vomiting
  • Diarrhea
  • Lightheadedness or fainting, which may be caused by low blood pressure
If the gangrene is widespread, sepsis can occur.
Gangrene of the Foot
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Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include:
  • Blood tests
  • Tests of the discharge and the tissue
  • Imaging studies looking for type and extent of damage

Treatment

Treatment of gangrene includes:
  • IV antibiotics—to treat infection
  • Debridement —surgical procedure to cut away dead and dying tissue, done to try to avoid gangrene from spreading
  • Supportive care, including fluids, nutrients, and pain medication to relieve discomfort
  • Blood thinners—given to prevent blood clots
  • Surgery may also be done to restore blood flow to the affected area
  • Amputation—removal of severely affected body part
  • Hyperbaric oxygen treatment—exposing the affected tissue to oxygen at high pressure may have some benefit

Prevention

To help reduce your chance of getting gangrene, take these steps:
  • If you have chronic health conditions, adhere to the treatment plan outlined by your doctor.
  • If you have diabetes, inspect your feet every day for cuts, sores, or wounds.
  • Care for any cuts, sore, or wounds promptly to avoid infection.
  • If you need surgery, ask your doctor about taking antibiotics. This is especially true if you need intestinal surgery.

RESOURCES

American Academy of Family Physicians http://www.familydoctor.org

American Diabetes Association http://www.diabetes.org

CANADIAN RESOURCES

Canadian Diabetes Association http://www.diabetes.ca

Health Canada http://www.hc-sc.gc.ca

References

A quick summary of the 6 types of necrosis. Pathology Student website. Available at: http://www.pathologystudent.com/?p=5770 . Accessed September 18, 2013.

Fujiwara Y, Kishida K, et al. Beneficial effects of foot care nursing for people with diabetes mellitus: an uncontrolled before and after intervention study. J Adv Nurs. 2011;67(9):1952-1962.

Gangrene. NHS Choices website. Available at: http://www.nhs.uk/Conditions/Gangrene/Pages/Introduction.aspx . Accessed September 18, 2013.

Gas gangrene. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated July 14, 2010. Accessed September 18, 2013.

Sepsis in adults. BSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated August 14, 2013. Accessed September 18, 2013.

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