Gangrene is a term used to describe the death of an area of the body.
•It develops when the blood supply is cut off to the affected part as a result of various processes, such as infection, vascular (pertaining to blood vessels) disease, or trauma.
•Gangrene can involve any part of the body; the most common sites include the toes, fingers, feet, and hands.
Two major types of gangrene exists:
1.Dry gangrene: which develops due to reduction of blood flow through the arteries.
•It appears gradually and progresses slowly.
•Mostly, the affected part does not become infected.
•In this type of gangrene, the tissue becomes cold and black, begins to dry, and eventually sloughs off.
•Dry gangrene is commonly seen in people with blockage of arteries (arteriosclerosis),diabetes, smoking and genetic factors.
2.Wet or moist gangrene: develops as a complication of an untreated infected wound.
•Swelling resulting from the bacterial infection causes a sudden stoppage of blood flow.
•Cessation of blood flow facilitates invasion of the muscles by the bacteria and multiplication of the bacteria because disease fighting cells (white blood cells) cannot reach the affected part.
•Gas gangrene is a type of wet gangrene caused by the bacteria known as Clostridia, which are a type of infection causing bacteria that grow only in the absence of oxygen. As Clostridia grow, they produce poisonous toxins and gas.
This condition is called gas gangrene.
CAUSES
The following conditions are risk factors for the development of gangrene:
•Injury or trauma, such as a crush injury, a severe burn
•Diseases that affect the circulation of blood, such as arteriosclerosis, diabetes, smoking
•Infection of wound
SYMPTOMS
Dry gangrene:
•The affected area becomes cold and numb.
•Initially, the affected area becomes red.
•Then, it develops a brown discoloration.
•Finally, it becomes black and shriveled.
Wet or moist gangrene:
•The affected area becomes swollen and decays.
•It is extremely painful.
•Local oozing occurs.
•It produces a foul smelling odor.
•It becomes black.
•The affected person develops fever.
Gas gangrene:
•A brown red or bloody discharge may ooze from the affected tissues.
•Gas produced by Clostridia may produce a crackling sensation when the affected area is pressed.
•It becomes swollen.
•Pain in the affected area is severe.
The affected person develops fever, increased heart rate, and rapid breathing if the toxins spread into the bloodstream
When to Seek Medical Care
Consult a health care provider immediately if the following signs develop:
•An area of the body turns blue or black.
•A wound does not heal in seven to14 days.
•Pain in a localized area is severe.
•Unexplained fever is persistent.
•Pus or blood drains from the wound.
•A foul smelling odor discharges from the wound.
DIAGNOSIS
The diagnosis of gangrene is based on history, physical examination, blood tests, and other tests.
Other tests includes:
Sample of drainage from the wound to identify the bacteria
X rays
CT Scan
MRI
Arteriogram
TREATMENT
Patients with gangrene should be treated urgently in order to prevent the spread of gangrene.
a.Dry gangrene: Because the cause of dry gangrene is a lack of blood flow, restoring the blood supply is vital.
Assessment by a vascular surgeon to determine whether surgical intervention to restore blood supply is necessary or not.
b.Wet gangrene: Surgical debridement (removal of dead tissue) of the wound is performed, and intravenous antibiotics are administered to control the infection.
c.Gas gangrene: This condition needs to be treated aggressively because the infection spreads rapidly via the bloodstream damaging vital organs.
The debridement of the wound should be done immediately.
Antibiotics should be administered to the affected person.
