Death of the tissue that may occur due to lack of blood flow or a serious bacterial infection is called gangrene. In most cases, this condition occurs in the arms and legs (including fingers and toes). However, it also may happen in the muscles and inside body organs (including the gallbladder).
There are some health conditions that cause damage to the blood vessels negatively affecting blood flow. These include diabetes, atherosclerosis (hardened arteries), and others.
Healthcare professionals usually prescribe antibiotics, oxygen therapy, and surgery that help to restore blood flow and remove dead tissue. Recovery chances depend on when gangrene is detected.
Symptoms
Check below some symptoms that appear when gangrene affects the skin:
- Swelling
- Blisters
- Severe pain and numbness that often occur suddenly
- A foul-smelling discharge leaking from a sore
- Shiny and thin skin
- Skin that feels cold
- Skin color changes (from pale gray to blue, purple, black, bronze, or red)
Unwell feeling and low-grade fever may occur if this condition negatively affects other tissues beneath the skin’s surface (including gas gangrene or internal gangrene).
Sometimes, septic shock may occur due to germs that spread throughout the body. Check below some symptoms of septic shock:
- Hypotension (low blood pressure)
- Fast heart rate
- Fever
- Lightheadedness
- Shortness of breath
- Confusion
However, gangrene is a serious health condition that requires emergency treatment. If you experience any of the following symptoms, immediately seek medical care. Examples include:
- Persistent pain or fever
- Skin changes (including warmth, swelling, blisters, lesions, or discoloration)
- Skin that is cold and numb
Causes
The main gangrene causes include:
- Lack of blood supply – The blood carries oxygen and nutrients required by the body. Moreover, it provides the body’s defense (immune system) with antibodies that fight infections. If blood flow is blocked the cells cannot survive and begin to die.
- Infections – If you ignore the symptoms and do not get treatment for bacterial infections it may lead to gangrene.
- Traumatic injury – The bacteria can enter the body through gunshot wounds or crushing injuries from car accidents. If these bacteria remain untreated, it also may lead to the death of the tissue.
Gangrene Types
- Dry gangrene – It occurs mostly in people with diabetes or blood vessel disease (including atherosclerosis). This gangrene type looks brown to purplish-blue or black.
- Wet gangrene – The common features of this gangrene type include swelling, blisters, and a wet appearance. It happens when bacteria infect the tissue. In most cases, this type occurs after a severe burn, frostbite, or injury.
- Gas gangrene – In most cases, this gangrene type negatively affects the deep muscle tissue but the skin surface looks normal in the beginning. The skin color may turn to pale or other colors including gray or purplish red as gangrene worsens. In most cases, gas gangrene is caused by a bacteria (known as Clostridium perfringens).
- Internal gangrene – This type of condition usually negatively affects either one or more internal organs including the gallbladder, appendix, or intestines. Commonly, it occurs when blood flow is blocked to these organs.
- Fournier’s gangrene – This gangrene type usually affects the genital organs. In most cases, it impacts males but females also can experience it. The main causes of Fournier’s gangrene include urinary tract infections or genital area infections.
- Meleney’s gangrene – This type occurs quite rarely and happens as a complication of surgery. The symptoms (such as painful skin lesions) occur after a few weeks after surgery. Sometimes, doctors call this gangrene type progressive bacterial synergistic gangrene.
Risk Factors
The following things may elevate your risk of gangrene. Examples include:
- Diabetes – Increased sugar levels in the blood may damage blood vessels leading to decreased blood flow.
- Blood vessel disease – Narrowed and hardened arteries (atherosclerosis) and blood clots may prevent blood flow to certain body parts.
- Severe injury or surgery – The risk of gangrene increases due to any process (such as frostbite) that leads to trauma of the skin and underlying tissue.
- Smoking – Those who use tobacco products are at increased risk of developing gangrene.
- Obesity – Extra body weight may push arteries causing blood flow to slow, which leads to poor wound healing and increased risk of infection.
- Immunosuppression – There are certain medicines and procedures that lower the immune system’s ability to fight infections. These include chemotherapy, radiation therapy, and immunosuppressant medicines. However, the function of the immune system can be reduced by certain infections including HIV (human immunodeficiency virus) infection.
- Injections – There are some injectable medicines linked with bacteria that cause gangrene. However, it occurs quite rarely.
- Coronavirus disease 2019 (COVID-19) complications – There are some reports of people who developed dry gangrene in the fingers and toes after COVID-19. However, more research is required to confirm the link between gangrene and COVID-19.
Complications
Serious complications may occur in people who do not treat gangrene. For instance, bacteria that cause gangrene usually spread quickly to other organs and tissues, which may lead to removing of a body part (amputating) that helps to save the life. Moreover, after removal of infected tissue scarring may occur which requires reconstructive surgery often. Discuss with your healthcare provider for more details.
Prevention
Check below some tips that may help to reduce the risk or prevent gangrene:
- Treat diabetes – People with diabetes should monitor regularly their blood sugar. They should also check their hands and feet for cuts, sores, and infection symptoms (including redness, swelling, or drainage).
- Try to lose weight – People high in weight should try to lose weight because it will help to reduce pressure on the arteries.
- Quit smoking – Discuss with your healthcare professional about smoking cessation programs if you are facing problems with quitting smoking.
- Regularly wash your hands, especially open wounds.
- Check for frostbites – Frostbites may slow down blood flow and cause gangrene. Contact a healthcare professional right away if you notice that your skin is pale, hard, cold, and numb after spending time in cold temperatures.
Diagnosis
Doctors usually perform the following tests to confirm the condition. For example:
- Blood tests – These tests are usually done to check for infection symptoms, bacteria, and other germs. Increased white blood cell count usually is a symptom of infection.
- Tissue or fluid culture – For this test, doctors will get a sample of skin blister and send it to the laboratory for testing.
- Imaging tests – These include X-rays, CT (computerized tomography) scans, and MRI (magnetic resonance imaging) scans. Previous tests help doctors get detailed images of blood vessels, organs, and bones.
- Surgery – This procedure may be used to look inside the body and learn more about infected tissue.
Treatment
Unfortunately, damaged tissue cannot be saved and treatments prescribed by doctors focus on preventing gangrene from worsening. Check below some treatment options usually recommended by doctors for people with gangrene:
- Surgery
- Medicines
- Hyperbaric oxygen therapy
Medicines
Doctors usually prescribe antibiotics to treat bacterial infections, which are usually given IV (intravenously). Sometimes, physicians may recommend some pain relievers.
Surgery and Other Procedures
According to the type and severity of the gangrene, some people require either one or more surgeries. Check below some types of surgery involved in gangrene treatment:
- Debridement – This surgery helps people remove infected tissue and slow down the spreading of the infection.
- Vascular surgery – It involves the repair of damaged or diseased blood vessels that help to restore blood flow to the affected area.
- Amputation – This surgery is used in severe cases to remove a body part that is infected (such as a toe, finger, arm, or leg). After surgery, you may be fitted with an artificial limb (also called a prosthesis).
- Skin grafting – Sometimes, after surgery, skin grafting (also called reconstructive surgery) is needed due to scars that appear after the removal of the infected skin.
Hyperbaric Oxygen Therapy
This procedure involves a chamber pressurized with pure oxygen. The patient usually lies on a table that is located in a clear plastic tube. After that, the atmospheric pressure inside this chamber will increase slowly to approximately 2.5 times. This procedure helps blood carry more oxygen, which improves wound healing.
Frequently Asked Questions
What are the most common causes of gangrene?
- HIV infection
- Obesity
- Frostbite
- Skin infection
- Raynaud’s syndrome
- Hypertension (high blood pressure)
- Surgery
- Atherosclerosis
- Peripheral artery disease
- Injury
- Misuse of alcoholic drinks
- Smoking
- Vasculitis
- Diabetes
- Burns
- Kidney failure
If you are at increased risk of developing gangrene, you should visit a doctor right away.
Can gangrene be fatal?
The bacteria that causes this condition spreads quickly and without treatment, death can occur within 48 hours. If you suspect you have this condition, immediately seek medical care.
What are the most common symptoms of gangrene?
These include:
- Coldness, numbness, pain, redness, or swelling in the affected area
- Skin color changes or discoloration
- Sores or blisters
If you have additional questions, ask your healthcare provider.
