Gangrene

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Overview

Gangrene is a term describing the dead or dying tissue, which is due to decreased blood intake locally inadequate to keep tissue alive.

Medical use of the term includes any matter which compromises blood supply, leading to tissue death. Therefore, a person can be diagnosed without being infected with gangrene.

 

Contents

1. Overview
2. Causes
3. Risk factors
4. Symptoms
5. Diagnosis
6. Treatment
7. Prevention

Causes

Causes of gangrene are very different, depending on its type. The most common two types of gangrene are:

- dry gangrene
- wet gangrene

1. Dry gangrene is usually caused by a health condition that disrupts blood flow to certain parts of the body, most commonly in the toes and feet. Conditions that may be associated with dry gangrene include:

- Type 1 diabetes, type 2 diabetes – high blood sugar levels associated with these conditions may affect blood vessels
- atherosclerosis – where blood arteries narrow and clogged with plaque
- peripheral arterial disease – the buildup of fatty deposits in arteries restricts blood flow to muscles legs

2. Wet gangrene often occurs when a severe injury, burns or frostbite is infected with bacteria. Swelling caused by infection can block the blood supply to the affected area, which worsens the infection. Wet gangrene can spread much faster than dry gangrene and may appear life-threatening manifestations such as septic shock, unless prompt treatment occurs.

3. Other types of gangrene include:

- gas gangrene – which occur when an infection develops deep inside the body and the bacteria involved begin to release toxins
- necrotizing fasciitis – occurs when bacteria spread through skin and into the surrounding tissue.
- internal gangrene – when blood flow to an internal organ (such as the gall bladder) is blocked. This type of gangrene often occurs as a complication of a hernia.

Risk factors

Among the risk factors of developing gangrene include:

- age – gangrene is more common in older people
- diabetes – high blood, as the specific diabetes can affect nerves, especially the leg nerves. When nerves are damaged, the patient feels no pain and do not know if they suffer any injury or damage to the skin. As such he will continue to walk free without protecting the wound that will fester and will develop ulcers. Elevated blood glucose can damage blood vessels, which will lead to improper blood supply to the area. Less blood means less nutrients and oxygen to tissue cells, and also fewer white blood cells and T cells that fight infection. Ulcers will become infected, the infection will worsen rapidly and will develop gangrene.
- injury or surgery – about 40% of wet gangrene are caused by surgical infections and about 50% are caused by serious injuries. Gangrene caused by frostbite and injuries resulting from use of firearms are less common than are due to motor vehicle accidents, crush injuries, burns and industrial accidents.
- weakened immune system
- smoking – smoking causes narrowing of blood vessels and blood flow will be reduced.

Symptoms

Manifestations depends on the location and the cause of gangrene.

If the skin is involved or gangrene is close to the skin, symptoms may include:

- changes in skin color – blue or black if it is damaged or red if the affected area is under the skin
- presence of foul-smelling discharge
- loss of local sensation (which can happen after severe pain in area)

If the affected area is inside the body (such as gallbladder gangrene or gas gangrene) symptoms may include:

- confusion
- fever
- gas present in the tissues under the skin
- malaise
- hypotension
- severe or persistent pain.

Diagnosis

Your doctor may diagnose gangrene after a physical examination. In addition, can be used to detect gangrene following tests and procedures:

- arteriogram – X-ray investigation which can visualize any blockages of blood vessels – recommended for this blood vessel disease
- blood tests
- CT examination of internal organs
- culture of tissue or fluid from wounds to identify bacterial infection
- microscopic examination of tissue to look for any dead cells
- surgery for finding and removing dead tissue
- X-ray radiography

Treatment

People diagnosed with gangrene require rapid assessment and treatment to avoid preventing the spread of gangrene. Antibiotics and surgery are the treatments of first choice and proved to be very effective. Is required hospitalization for treatment.

- Dry gangrene – as dry gangrene is due to lack of blood flow is vital to restore the blood supply through surgery. Evaluation by a vascular surgeon can determine if surgery will be beneficial.

- Wet gangrene – treatment involves surgical removal of dead tissue from the affected area, and intravenous antibiotics to keep infection under control.

- Gas gangrene – condition should be treated aggressively because of the threat of rapid infection that can spread through blood and can damage vital organs. Require immediate wound debridement. Antibiotics will be given as soon as possible.

Prevention

- Foot care – If you have diabetes, examine your hands and feet regularly in order to have no cuts, sores and signs of infection. Go to the doctor to consult for the same purpose, at least once a year.
- Do not smoke, because this harmful habit affects blood vessels increasing the risk of gangrene.
- Treat wounds promptly – if you cut or supports any skin lesion, wash it with warm water and mild soap and keep it clean and dry until it heals.
- Frostbite – If the skin becomes pale, cold and numb due to excessive cold consult your doctor immediately.

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