Gangrene: Treatment, symptoms, advice and help
Gangrene is a serious disorder which is defined as the death of some body tissue due to impaired blood supply to that area. It may involve any part of the body but most commonly affects toes, fingers, arms and legs. However in rare instances, the internal body organs and muscles may also get affected by gangrene. Gangrene may be of different types, namely dry, wet, gas and internal gangrene.
Gangrene: Incidence, age and sex
Gangrene usually occurs in older adults especially above 50 years of age. It is very rare in children or healthy adults. It usually appears in individuals, who have some blood flow disorder or physical trauma or hampered immunity.
Signs and symptoms of gangrene: Diagnosis
The exact clinical features depend upon the type of gangrene and its location. Involvement of extremities may manifest with progressive discolouration of skin which may become blue or black. Pus may also get collected at the gangrenous site which typically has a foul odour. Physical examination of affected area by a specialist may reveal numbness and loss of sensation. Gangrenous tissue can get infected with bacteria which may be exhibited by presence of fever and increased heart rate. Gangrene in internal organs or deep muscles is a serious condition which may be exhibited by high fever, low blood pressure, increased heart rate, intense pain over affected site and mental confusion in later stages. Gangrene in the deep muscles sometimes produces gas which gets trapped between tissues. Hence, when such tissue is pressed upon during physical examination, a crackling sound (due to movement of gas) can be heard.
Gangrene, if superficial, can be diagnosed on physical examination. Microscopic examination and culture of affected tissue and tissue fluids may help in establishing the diagnosis. Imaging modalities like CT and MRI scans helpss in detecting gangrene of the internal organs.
Causes and prevention of gangrene
The body tissues normally require oxygen for survival which is supplied by oxygen carrying cells in blood. Any condition, which hampers the blood supply, may lead to reduced or no oxygen to the tissues which leads to their death eventually. This phenomenon is called gangrene. Several causes are responsible for appearance of gangrene most common of which are physical trauma, including accidents or surgery. Certain blood disorders like atherosclerosis or blood clots which can impede the flow of blood can also cause gangrene. Diabetes is a serious disorder which can cause gangrene, most commonly of the feet, if the blood sugar levels are not controlled.
The occurrence of gangrene may be prevented by smoking cessation, avoiding alcohol, regular examination of feet, especially in diabetics and proper, timely management of wounds.
Gangrene is a serious problem which if neglected, may spread to adjacent body parts. Once the tissue dies, it cannot be revived and needs to be removed. This also involves amputation of extremities, if needed. Amputation leads to physical disability which can be a cause of great emotional and physical distress for the affected individual.
Gangrene is a medical emergency which requires urgent medical evaluation and management. The treatment modalities include both medications and surgical intervention. The treatment depends upon the cause and site of gangrene. If the gangrene results from disorder of blood vessel, then it is important to surgically repair that blood vessel and restore normal blood flow. Repeated episodes of debridement of affected tissue may be required. If the tissue is totally dead, then it needs to be completely removed surgically and prevent its spread to adjacent body parts. Amputation of extremities may be needed in severe tissue destruction. A long course of oral or intravenous antibiotics is mandatory to prevent bacterial infection. Sometimes reconstructive surgery in form of skin grafting needs to be done in cases of extreme mutilation of skin.