Gangrene
(Dry Gangrene; Gas Gangrene; Organ or Tissue Death; Wet Gangrene)
Definition
- Dry gangrene—lack of blood supply causes the tissue to dry up and slough off
- Wet gangrene—usually occurs when the tissue is infected with bacteria, tissue becomes moist and breaks down
- Gas gangrene—a particular type of bacteria (Clostridia) produces gas bubbles in the tissue
Causes
- Infection, especially after surgery or injury
- Diabetes
- Any condition that blocks blood flow to tissue (such as, atherosclerosis)
Risk Factors
- Smoking
- Alcohol use
- Traumatic injury, especially crushing injuries
- Wound infection after surgery
- Frostbite
- Burns
- Atherosclerosis
- Diabetes
- Raynauds disease
- Blood clots
- Ruptured appendix
- Hernia
- IV drug use
Symptoms
- Swelling
- Pain, followed by numbness when the tissue is dead
- Sloughing off of skin
- Color changes, ranging from white, to red, to black
- Shiny appearance to skin
- Frothy, clear, watery discharge
- Fever and chills
- Nausea and vomiting
| Gangrene of the Foot |
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Diagnosis
- Blood tests
- Tests of the discharge and the tissue
- X-ray—a test that uses radiation to take pictures of structures inside the body
- CT scan—a type of x-ray that uses a computer to make pictures of the inside of the body
- MRI scan—a test that uses magnetic waves to make pictures of the inside of the body
Treatment
- Antibiotics—given through IV in a very potent form
- Blood thinners—given to prevent blood clots
- Debridement—surgical procedure to cut away dead and dying tissue, done to try to avoid gangrene from spreading
- Amputation— removal of severely affected body part (such as, toe or foot amputation, above-the-knee amputation)
- Hyperbaric oxygen treatment—involves exposing the affected tissue to oxygen at high pressure
Prevention
- If you have diabetes, take good care of your hands and feet.
- 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.aafp.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
Cecil RL, Goldman L, et al. Cecil Textbook of Medicine. 21st ed. Philadelphia, PA: WB Saunders Company; 2000.
Conn HF, Rakel RE. Conn's Current Therapy 2001. 53rd ed. Philadelphia, PA: WB Saunders Company; 2001.
Gas gangrene. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated June 2008. Accessed June 24, 2008.
Mandell GL, Douglas RG, et al. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, PA: Churchill Livingstone; 2000.
Rosen P, et al. Emergency Medicine: Concepts and Clinical Practice. 4th ed. St. Louis, MO: Mosby-Year Book; 2000.
