Download Gangrene - Patient Education Institute

Gangrene
Introduction
Gangrene is the death of tissues in your body. It happens when a part of your body
loses its blood supply.
Gangrene can happen on the surface of the body, such as on the skin. It can happen
inside the body in muscles or organs. Gangrene can be caused by a number of health
problems, including serious injuries, infections, problems with blood circulation and
diabetes.
This reference summary explains what gangrene is and what causes it. It also covers
the diagnosis and treatment of gangrene.
Gangrene
Gangrene is the death of tissues in your body. It
may be caused by a lack of blood flow to a part of
the body or by a bacterial infection. Blood helps
distribute the nutrients, oxygen and hormones the
body needs. It also carries toxins and waste
materials to the liver and kidneys to be removed
from your body.
When blood flow is blocked, the body suffers.
Tissues die if they don’t get the oxygen and nutrients
carried by the blood. When this happens, health
problems like gangrene can develop.
The Circulatory
System
Gangrene
There are 2 main types of gangrene:
• Dry gangrene, which is caused by diseases that affect blood circulation.
• Wet gangrene, which is caused by a wound infected with bacteria.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 06/08/2016
idfq0101
1
Gangrene may be described with names other than dry or wet depending on where or
how it develops. For example, wet gangrene that is caused by the bacteria Clostridia is
called gas gangrene. It gets its name from a poisonous gas released by the Clostridia
bacteria. Any body part can be affected by gangrene, but it most often develops in the
hands, feet, fingers and toes. Gangrene can also happen inside of your body, in the
muscles and organs.
Symptoms
When gangrene is located on the skin, symptoms may include:
• Discolored skin, which may appear blue, purple, black, bronze or red.
• Foul-smelling discharge from a wound or sore.
• Severe pain in the affected area followed by
numbness, or a loss of sensation.
When gangrene is located beneath the surface of the skin,
symptoms may include:
• Feeling sick or ill.
• Fever.
• Swelling and pain in the affected area.
If bacteria move from the affected tissue and infect other
tissues throughout the body, it may cause septic shock.
Symptoms of septic shock are:
• A temperature greater than 100.4° Fahrenheit or
lower than 96.8° Fahrenheit.
• Confusion.
• Lightheadedness.
• Low blood pressure.
• Rapid heart rate.
• Shortness of breath.
Call your health care provider right away if you have
ongoing, unexplained pain in any area of your body
along with one or more of the following symptoms:
• Fever.
• Skin changes that won’t go away, including discoloration, warmth, swelling,
blisters or lesions.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 06/08/2016
idfq0101
2
You should also contact your health care provider if you have ongoing, unexplained
pain and one or more of these symptoms:
• A foul-smelling discharge leaking from a sore.
• Skin that is pale, hard, cold and numb.
• Sudden pain at the site of a recent surgery or trauma.
Causes
Gangrene is caused by one or both of the following:
• Lack of blood supply.
• Bacterial infection.
Health care providers use different names for gangrene
based on its cause or location.
The three most common causes include:
• Dry gangrene, which is caused by blood vessel diseases.
• Wet gangrene, which is caused by a bacterial infection or diabetes.
• Gas gangrene, which is caused by infection with the bacterium Clostridium.
Other, less common, causes of gangrene are given different names:
• Internal gangrene.
• Fournier's gangrene.
• Meleney's gangrene.
Internal gangrene happens when blood flow to an internal organ is blocked. For
example, internal gangrene may develop after a hernia. A hernia happens when the
intestines push through a weakened area of muscle in your abdomen. Internal
gangrene most often affects the intestines, gallbladder or appendix. Fournier's
gangrene is a rare type of gangrene caused by an infection in the genital area or
urinary tract. It involves the genital organs. Men are more often affected, but women
can also develop this type of gangrene.
Meleney’s gangrene is also known as bacterial synergistic gangrene. It is a rare type of
gangrene caused by a bacterial infection after a surgical operation. Painful skin lesions
develop one to two weeks after surgery. Bacterial synergistic gangrene is caused by
the interaction of two or more bacteria. Their combined effect is greater than the effects
seen when each bacteria acts alone.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 06/08/2016
idfq0101
3
Risk Factors
Health care providers know of several factors that increase your risk for gangrene.
Having a risk factor does not mean you will develop gangrene. But you are more likely
to develop it than somebody without a risk factor. Sometimes people with no risk
factors develop gangrene.
One risk factor for gangrene is age. People older than 60 years of age are diagnosed
with gangrene more often than younger people. As people get older, their heart and
blood vessels change. Blood may have a harder time getting to the tissues that need it
most. This raises the risk for gangrene.
Having diabetes is another risk factor. Diabetes prevents your
body from getting rid of a special kind of sugar in your blood.
High blood sugar levels can damage blood vessels and
interrupt blood flow to some parts of the body. This raises the
risk for gangrene.
People that suffer a severe injury or undergo surgery have an
increased risk for gangrene. Any time something causes trauma to your skin and the
tissue underneath it, such as trauma from frostbite or burns, the risk for gangrene
increases.
Obesity is also a risk factor. Obesity is linked to health problems
related to gangrene, including diabetes and vascular disease.
The stress of extra weight may constrict arteries, which also
reduces blood flow. Reduced blood flow increases the risk of
infection and causes wounds to heal poorly.
Another risk factor for gangrene is having a weakened immune
system. Immune systems may become weak due to diseases,
such as HIV/AIDS, or certain medical treatments. For example, chemotherapy and
radiation therapy reduce the body’s ability to fight off infection.
Certain blood thinning medications can also raise the risk for gangrene, but this is rare.
Warfarin, also known as Coumadin®, is an example of a commonly used blood
thinning medication. Talk to your health care provider to find out if any of the
medications you take raise your risk for gangrene.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 06/08/2016
idfq0101
4
Diagnosis
A health care provider can diagnose gangrene in several ways. Blood tests may be
used to check for signs of an infection. Imaging tests can look at areas inside the body
to see if gangrene is present and if it has spread. Some examples of imaging tests are
x-rays, MRIs and CT scans. An MRI uses radio waves and a powerful magnet linked to
a computer to create detailed pictures of areas inside the body. These pictures can
show the difference between normal and abnormal tissue. A CT scan uses a computer
linked to an x-ray machine to take detailed pictures of areas inside the body from
different angles.
An arteriogram may be used to check blood flow in the
arteries. During this test, dye is injected into the
bloodstream and x-ray pictures are taken to see how well
the blood moves. This test helps your health care provider
find blocked arteries, which could cause gangrene.
A tissue culture may be used to look for signs of infection.
Fluid may also be taken from a blister on your skin and
examined for the bacterium Clostridium. Sometimes
surgery is used to determine how far gangrene has
spread within the body.
Arteriogram
Treatment
There is no treatment to reverse the damage caused by gangrene. The tissue cannot
be saved. Instead, the goal of treatment is to prevent the spread of gangrene. This
section reviews the different treatment methods most commonly used to stop gangrene
from affecting other tissues in the body.
Surgery is often used to remove dead tissue. This prevents
gangrene from spreading and allows healthy tissue to heal. If
possible, a surgeon will also repair damaged or diseased blood
vessels. This can increase blood flow to the affected area.
Reconstructive surgery may be used to replace damaged skin.
Healthy skin is taken from another part of your body, usually a
place hidden by clothing. This healthy skin is carefully spread over
the affected area. It is held in place by a dressing or by a few small
stitches until it heals.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 06/08/2016
idfq0101
5
Sometimes the removal of an affected body part is necessary to prevent the spread of
gangrene. This is known as an amputation. It is used only in severe cases of
gangrene. Amputation is most often used to remove a toe, finger, arm or leg. It can
also remove a gall bladder, appendix or segment of intestine affected by gangrene.
Medicine may be used to treat an infection caused by gangrene. Intravenous
antibiotics are special drugs used to fight off harmful bacteria. Intravenous, or IV, refers
to a way of giving a drug through a needle or tube inserted into a vein. They are
usually given if your health care provider prescribes antibiotics, it is important that you
take them exactly as prescribed until all of the medication is gone.
Oxygen can also be used to treat certain types of
gangrene. Hyperbaric oxygen therapy may be an
effective treatment for gas gangrene. It provides a higher
than normal level of oxygen to the body, which helps
slow the growth of certain bacteria. It also helps infected
wounds heal more easily.
Hyperbaric Oxygen
In hyperbaric oxygen therapy, you are placed in a
Therapy
special chamber that is pressurized with pure oxygen.
You may spend about 90 minutes in the chamber up to three times in one day. This
may be followed by twice-daily treatments for up to five days.
Prevention
You may be able to reduce your risk for developing gangrene. If you have diabetes,
you should regularly examine your body for injury. Check for cuts on your hands and
feet daily. Also looks for sores and signs of infection, such as redness, swelling or
drainage. Finding and treating wounds early can help prevent complications.
If you are overweight, create a diet or exercise plan to help you lose weight. Extra
pounds increase your risk for diabetes and damage your arteries. This restricts blood
flow and puts you at risk for infection and slow wound healing. Always talk with a
healthcare provider before starting a new diet or exercise program.
If you smoke or use other tobacco products, quit. Using tobacco products damages
your blood vessels. If blood stops flowing to the areas that need it, you may develop
gangrene.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 06/08/2016
idfq0101
6
Avoid prolonged exposure to cold temperatures. Frostbite can lead to gangrene
because it reduces blood circulation to the affected area. If you notice that an area of
skin has become pale, hard, cold and numb after being exposed to the cold, call a
health care provider.
Summary
Gangrene is the death of tissues in your body. There are two major types:
• Dry gangrene, caused by a lack of blood flow to an area of the body.
• Wet gangrene, caused by a bacterial infection.
Gangrene can happen on the surface of the body, such as on the skin. It can happen
inside the body in muscles or organs. Symptoms differ depending on what caused it
and where it is located. Symptoms may include discolored skin, swelling and pain in
the affected area, foul-smelling discharge, fever and other
problems.
Treatment is meant to stop the spread of gangrene. Surgery,
amputation, antibiotics and hyperbaric oxygen therapy may
be used. A skin graft can help cover a visible area of the
body that has been damaged by gangrene.
Gangrene can be prevented by taking care of your body.
Maintaining a healthy weight, quitting smoking, controlling
health problems like diabetes and avoiding extremely cold
temperatures are some of the ways gangrene can be
prevented.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 06/08/2016
idfq0101
7