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Gangrene
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Gangrene is a condition of tissue death and decay that results from a lack of blood supply to a particular body area. Many cases of gangrene are involved also with bacterial infection and some can be infected with maggots. Gangrene is most common in the toes, fingers and the extremities but can happen in the internal organs and within muscles of the body. Gangrene is most common in those who have atherosclerosis or diabetes-common conditions that affect circulation.
Gangrene most commonly shows up on the skin. It causes a blue or black color to the skin which is associated with numbness or pain to the affected area. The gangrenous area can be foul smelling from the bacteria invading the dead tissue. If you have gas gangrene or gangrene that is located beneath the skin, the affected tissue can be very painful and swollen in nature and you will feel sick. You may have a fever.
As the gangrene invades the body, you can come down with septic shock, which can be fatal. Signs and symptoms that are common when you have septic shock along with gangrene are low blood pressure, light headedness, a rapid heartbeat, confusion and shortness of breath.
There are different types of gangrene that a person can get. These include "dry gangrene" in which the skin is dry and shriveled up. The skin is brown, purple in color or black. It develops slowly and is common in those who have atherosclerotic blood vessel disease. "Wet gangrene" happens when a bacterial infection has invaded the tissue. There is a wet appearance to the skin and blistering of the skin. It is common after a severe burn, an injury or a frostbite injury. It is common also in diabetics with poor circulation to the distal extremities. This type of gangrene can spread quickly and must be treated immediately. "Gas gangrene" affects the muscles underneath the skin. The skin might actually look normal but there is crackling and bubbling beneath the surface of the skin. The skin eventually appears as a gray or purple/red color. Gas forms within the tissue from the bacteria invading the muscle.
Gas gangrene is caused by the organism called Clostridium perfringens, which takes over after a surgical experience or injury has badly affected the blood supply. Toxins produce the gas that is trapped within the soft tissue and muscle. It is a serious form of gangrene.
Internal gangrene can affect the bowels, small intestines, gallbladder or your appendix. It happens when the blood flow to the tissues is blocked, such as when you have a herniation that twists, a volvulus or intusception of the bowel. Internal gangrene is very painful and you can have a fever because of it. It can be fatal if not discovered and treated promptly.
There is a type of gangrene called Fournier's gangrene. This affects primarily the male genitalia but women can sometimes be affected by this form of gangrene. It is commonly caused by a urinary tract infection.
Risk factors for gangrene include advancing age, diabetes, or atherosclerosis. A serious injury or major surgery can trigger the onset of gangrene. Those who are immunosuppressed are at greater risk of getting gangrene than are those who have normal immune systems.
Complications of gangrene include scarring of the skin, amputation of an affected body part or other reconstructive surgery. If dry gangrene is left untreated, it can turn into wet gangrene and can be severely dangerous, leading to death in some cases.
Testing for gangrene involves evaluating the area for signs and symptoms of the disease, taking blood samples which might show evidence of infection. Blood cultures might show some bacteria growing in the bloodstream. CT scans or MRI scans can look for gas gangrene or gangrene that has affected the deeper structures of the body. Arteriograms can be used to find out where the circulation is impaired, especially when an amputation is suggested.
Treatment of gangrene includes surgery to debride the dead tissue. Amputations may be necessary, depending on where the gangrene is located and how advanced the gangrene is. Fluid cultures or tissue cultures can be done to help determine what antibiotics to use. Skin grafting may be necessary if a great deal of the skin is affected. Hyperbaric oxygen therapy is used to maximize the oxygenation of the tissue. Clostridium perfringens is anaerobic, meaning it is easily killed off by the presence of oxygen.