Gangrene

An Overview

Gangrene is death of body tissue due to a lack of blood flow or a serious bacterial infection. Gangrene commonly affects the arms and legs, including the toes and fingers, but it can also occur in the muscles and in organs inside the body, such as the gallbladder. It usually happens in extremities like fingers, toes, and limbs, but you can also get gangrene in your organs and muscles. There are different types of gangrene, and all of them need medical care right away. The condition typically starts in a specific body part, such as a leg, hand, or internal organ. Gangrene can spread through your body and cause you to go into shock if left untreated. Shock is a condition marked by a variety of symptoms including low blood pressure.

Shock can be life-threatening and is considered a medical emergency.
Your risk of gangrene is higher if you have an underlying condition that can damage your blood vessels and affect blood flow, such as diabetes or hardened arteries (atherosclerosis). Treatments for gangrene include surgery to restore blood flow and remove dead tissue, antibiotics if there is an infection, and hyperbaric oxygen therapy. The earlier gangrene is identified and treated, the better your chances for recovery.

Types of Gangrene

Dry gangrene: This is more common in people who have vascular disease, diabetes, and autoimmune diseases. It usually affects your hands and feet. It happens when something — often, poor circulation — blocks blood flow to a certain area. As your tissue dries up, it changes color.
Wet gangrene: This type almost always involves an infection. Burns or trauma in which a body part is crushed or squeezed can quickly cut off blood supply to the area, killing tissue and raising the odds of infection. The tissue swells and blisters; it’s called “wet” because it causes pus.
Internal gangrene: This is gangrene that affects your internal organs. It’s usually related to an infected organ such as your appendix or colon.
Gas gangrene: Gas gangrene is rare but especially dangerous. It happens when you get an infection deep inside your body, such as inside muscles or organs, usually because of trauma. Bacteria called clostridia release dangerous toxins or poisons, along with gas that can be trapped in your tissue.
Fournier’s gangrene: Also a rare condition, Fournier’s gangrene is caused by an infection in your genital area. It affects men more often than women. If the infection gets into your bloodstream, a condition called sepsis, it can be life-threatening.
Progressive bacterial synergistic gangrene (Meleney’s gangrene): This type usually causes painful lesions on your skin 1 to 2 weeks after surgery or minor trauma. It’s also rare.

Symptoms for Gangrene

General symptoms of gangrene include:
• Initial redness and swelling
• Either a loss of sensation or severe pain in the affected area
• Sores or blisters that bleed or release a dirty-looking or foul-smelling discharge (if the gangrene is caused by an infection)
• The skin becoming cold and pale
• A high temperature of 38C or above
• Feeling hot and shivery
• Loss of appetite
• Rapid heartbeat and breathing
• Dizziness
• Pain or throbbing in or near the affected area
• Warmth of the affected area
• An open, non-healing wound
• A pus-filled lesion
• A wound that smells bad
• A fever can develop
• The affected area may be cool to the touch
• The affected area may feel cold as if it is “bare,” even when covered

Without treatment the affected tissue will start to die. When this happens, the area changes colour from red to brown to purple or black, before shrivelling up and falling away from the surrounding healthy tissue.

Causes of Gangrene

Diabetes: People with diabetes have an increased risk of developing gangrene. This is because the high blood sugar levels associated with the condition can damage your nerves, particularly those in your feet, which can make it easy to injure yourself without realising.
1. Injuries and surgery: You’re also at an increased risk of developing gangrene if you experience a traumatic injury or serious damage to your skin and tissues, such as:
• a serious injury – for example, during a car accident
• a burn
• frostbite
These injuries can cause a sudden loss of blood to an area of your body, and any open wounds can become infected with bacteria.
2. Weak immune system: If your immune system is seriously weakened, minor infections can become more serious and can lead to gangrene. A weak immune system can be caused by:
• chemotherapy or radiotherapy
• HIV
• diabetes
• long-term alcohol misuse
3. Kidney failure
4. Neuropathy:  A condition characterized by decreased sensation of the hands and feet, neuropathy does not directly cause gangrene. However, it substantially increases the chances of developing gangrene because it reduces your ability to adequately feel pain—a sensation that normally protects you from injuries and infections

Diagnosis

Your doctor may suspect that you have gangrene based on your medical history and symptoms. They may also use a combination of additional diagnostic methods to determine your condition.
1. Lab analysis of tissue or fluid samples
A scraping of tissue from your affected body part may be examined with a microscope to look for dead cells.
2. Blood tests
An abnormally high white blood cell count can indicate a gangrenous infection.
3. Medical imaging
Some kinds of imaging are helpful in diagnosing the spread of gangrene in your internal tissues. These tests could include X-rays, MRI scans, or CT scans.

Treatment

1. Antibiotics
Your doctor may prescribe antibiotics if bacteria are present. These are typically given intravenously, or through a needle directly into the bloodstream.
2. Vascular surgery
For people with poor circulation that results in gangrene, vascular surgery (surgery on the arteries or veins) may be recommended in order to improve the flow of blood through the veins to body tissues.
3. Hyperbaric oxygen chamber
Placing a person with gas gangrene in a special oxygen-rich environment can slow the growth of bacteria. This allows the skin to begin healing.

Prevention

People who have diabetes or a blood vessel disease should regularly check their hands and feet for gangrene symptoms. Watch for:
• Any swelling, discharge, or redness that may indicate infection
• A wound that does not seem to be healing
• A change in the color of your skin.

Hope this Symptoms and cure article will be helpful to all. Do not forget to share your valuable suggestions if any.

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