Gangrene: Causes, Symptoms, Risk Factors, Types and Diagnosis

The term "gangrene" refers to the death of body tissue brought on by a severe bacterial infection or a lack of blood flow. The arms, legs, toes, and fingers are typically affected by gangrene. In addition, vulnerable internal organs include muscles and the gallbladder.

Diseases that can stiffen arteries and block blood flow, such as diabetes or atherosclerosis, increase the risk of gangrene.

In addition to surgery to reestablish blood flow and remove dead tissue, gangrene treatments include oxygen therapy, antibiotics, and these.

The likelihood of recovery increases with the timing of gangrene diagnosis and treatment.

Causes Of Gangrene

A few gangrenous causes include the ones listed below:

• Blood supply problems. The blood is the body's primary source of both nutrients and oxygen. The immune system receives antibodies to fight infections as well. Cells cannot live and tissue deteriorates in the absence of sufficient blood flow.
• Infection. A bacterial infection that is not treated might lead to gangrene.
• Traumatic harm. Open wounds that allow bacteria to enter the body might result from gunshot wounds or crushing injuries from auto accidents. Gangrene can develop if the germs infect tissues and are left untreated.

Gangrenous foot disease

When blood flow to a particular area of the body is obstructed, gangrene develops. The absence of blood flow results in tissue death. Fingers and toes are frequently impacted by gangrene.

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Symptoms Of Gangrene

Signs and symptoms of gangrene that affect the skin include:

• Variations in skin tone, from mild grey to blue, purple, black, bronze, or red
• Swelling
• Blisters
• Sudden, intense pain is followed by numbness.
• A sore that is releasing an offensive-smelling discharge
• Thin, hairless, or skin that is glossy
• Touchable skin that has a cool or cold sensation
• If gangrene, such as internal or gas gangrene, targets the tissues under your skin, you can also have a low-grade fever and a general malaise.

If the bacteria that caused the gangrene spread throughout the body, septic shock may result. The warning signs and symptoms of septic shock include:

• Reduced blood pressure
• Even though some individuals' body temperatures may be lower than 98.6 F (37 C), fever
• Quick heartbeat
• Lightheadedness
• Breathing difficulty
• Confusion

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Types Of Gangrene 

• A Dry Gangrene-  Dry, shrivelled skin that ranges in colour from brown to purplish-blue or black indicates this type of gangrene. Dry gangrene may take time to develop. It is more likely to affect those with blood vessel disease, such as atherosclerosis or diabetes.
• A wet gangrene- Moist gangrene is the medical term for gangrene in which bacteria have penetrated the tissue. Oftentimes, wet gangrene features swelling, blistering, and a moist appearance. Wet gangrene may develop as a result of a severe burn, frostbite, or other injury. People with diabetes who accidentally hurt a body part frequently experience discomfort.
• Gas gangrene-  In most cases, deep muscular tissue is impacted by gas gangrene. Initially, the skin's surface may appear to be normal.
• Skin colour changes, such as grey or purplish red, may occur as the illness gets worse. The skin may initially start out pale. Possible bubbly skin appearance. The gas present inside the tissue may cause it to crackle when you press on it.
• The most frequent cause of gas gangrene is Clostridium perfringens bacteria. Without a blood supply, bacteria can flourish in surgical or trauma sites. The bacteria-produced toxins hasten tissue death by producing gas. Like wet gangrene, gas gangrene is a dangerous condition with a propensity for death.
• Internal gangrene-  Affected organs include the intestines, gallbladder, or appendix in cases of internal gangrene. When an internal organ's blood supply is cut off, it happens. As an illustration, it might occur if the intestines twist as a result of bulging through a weak spot in the stomach area's muscle. Internal gangrene is potentially fatal if untreated.
• Fournier's gangrene- Organs of the genital system are affected by this kind of gangrene. However, women can also contract it. It typically affects men. This type of gangrene is brought on by an infection of the urinary system or vaginal area.
• Meleney's gangrene-  It's a rare kind of gangrene. Commonly, it results from a surgical complication. One to two weeks following surgery, painful skin sores commonly develop. The condition's alternative name is progressive bacterial synergistic gangrene.

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Risk Factors Of Gangrene

The following factors can make gangrene more likely to occur:

• Diabetes. Blood arteries may eventually get harmed by high blood sugar levels. Damage to blood vessels can cause a segment of the body's blood flow to slow down or stop.
• Vascular disease. Blood clots and atherosclerosis, which harden and constrict the arteries, can both prevent blood from reaching a specific location in the body.
• Surgery or a severe injury. Any disease, including frostbite, that affects the skin and underlying tissue increases the risk of gangrene. The hazard is greater if you have a medical condition that limits blood flow to the injured area.
• Smoking. The risk of gangrene is higher in smokers.
• Obesity. A person's blood flow may be reduced, their risk of infection may rise, and their ability to repair wounds may be hampered by the pressure of extra weight on their arteries.
• Immunosuppression. Chemotherapy, radiation, and certain disorders, such as the human immunodeficiency virus (HIV), can have an impact on the body's ability to fight infections.
• Injections. Injection drugs and bacterial infections that cause gangrene have only sometimes been linked.

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Diagnosis Of Gangrene

The following tests are used to help identify gangrene:

• Blood test. Infection is frequently indicated by a high white blood cell count. To screen for the presence of particular bacteria and other pathogens, further blood tests might be performed.
• Culture of fluid or tissue. A fluid sample from a skin blister can be tested for germs. For evidence of cell death, a tissue sample can be examined under a microscope.
• Image-based tests. Organs, blood vessels, and bones can all be seen by X-rays, computerised tomography (CT) scans, and magnetic resonance imaging (MRI) scans. Surgery. Surgery may be performed to gain access to the internal organs and determine how much tissue is infected.

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Treatment Of Gangrene

It is impossible to repair gangrenous tissue. However, there are treatments that can stop gangrene from getting worse. Your chances of recovering are increased the sooner you receive therapy.

Gangrene can be treated with any combination of the following:

• Medications
• Surgery
• Medication for hyperbaric oxygen therapy
• Antibiotics are prescribed orally or intravenously (IV) to treat bacterial infections.
• Painkillers may be administered to ease discomfort.

Procedures such as surgery

More than one surgery can be required, depending on the nature and severity of the gangrene. Gangrene surgery entails:

• Debridement. To remove the contaminated tissue and stop the illness from spreading, this kind of surgery is performed.
• Vascular Surgery. In order to restore blood flow to the affected area, surgery may be performed to repair any broken or diseased blood vessels.
• Amputation. The infected body part, such as a toe, finger, arm, or leg, may need to be medically amputated in severe cases of gangrene. You might later have a prosthesis (artificial limb) fitted.
• Reconstructive surgery. Skin grafting rare occasions, surgery may be necessary to repair damaged skin or to hide gangrenous scars. Such a surgery may involve the use of a skin graft. When doing a skin graft, the surgeon covers the injured area with healthy skin from another part of the body..A skin graft can only be performed if the location has sufficient blood flow.

Hyperbaric oxygen treatment

A chamber pressurised with pure oxygen is used for hyperbaric oxygen therapy. Typically, you lie on a table that glides into a clear plastic tube. Slowly, the pressure inside the chamber will increase to around 2.5 times that of normal air pressure.

The blood can carry more oxygen when receiving hyperbaric oxygen therapy. Bacteria that reside in oxygen-deprived tissue develop more slowly in blood that is oxygen-rich. Additionally, it facilitates the quicker healing of infected wounds.

An average hyperbaric oxygen therapy session for gangrene lasts 90 minutes. Until the infection is gone, two to three treatments per day may be required.

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Prevention Of Gangrene

If gangrene is not treated right away, it might result in serious problems. Bacteria can swiftly infect more tissues and organs. To save your life, you might need to have a body part amputated.

When contaminated tissue is removed, there may be scarring or a need for reconstruction surgery.

Here are some methods to lower your chances of developing gangrene:

• Control your diabetes. If you have diabetes, controlling your blood sugar is crucial. Check your hands and feet frequently for cuts, sores, and signs of infection, such as swelling, redness, or drainage. Ask your doctor to examine your hands and feet at least once every year.
• Reduce body weight. People who are overweight have a higher risk of developing diabetes. Additionally, the weight puts pressure on the arteries, decreasing blood flow. Reduced blood flow impairs wound healing and increases the chance of infection.
• Avoid using cigarettes or smoking. Smoking cigarettes over an extended period of time harms blood vessels.

• Sanitise your hands. Maintain proper hygiene. Use gentle soap and water to clean any exposed wounds. 
• Do a frostbite check. Blood flow in the affected body area is decreased by frostbite. Call your healthcare practitioner if you experience pale, hard, cold, or numb skin after being in frigid weather.

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