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Gangrene Overview

Gangrene is a medical term used to describe the death of an area of the body. It develops when
the blood supply is cut off to the affected part as a result of various processes, such as infection,
vascular (pertaining to blood vessels) disease, or trauma. Gangrene can involve any part of the
body; the most common sites include the toes, fingers, feet, and hands.
Two major types of gangrene exist:

Dry gangrene is caused by a reduction of blood flow through the arteries. It appears
gradually and progresses slowly. In most people, the affected part does not become
infected. In this type of gangrene, the tissue becomes cold and black, begins to dry, and
eventually sloughs off. Dry gangrene is commonly seen in people with blockage of
arteries (arteriosclerosis) resulting from increased cholesterol levels, diabetes, cigarette
smoking, and genetic and other factors.

Wet or moist gangrene develops as a complication of an untreated infected wound.


Swelling resulting from the bacterial infection causes a sudden stoppage of blood flow.
Cessation of blood flow facilitates invasion of the muscles by the bacteria and
multiplication of the bacteria because disease-fighting cells (white blood cells) cannot
reach the affected part.
o Gas gangrene is a type of wet gangrene caused by the bacteria known as
Clostridia. Clostridia are a type of infection-causing bacteria that grow only in
the absence of oxygen. AsClostridia grow, they produce poisonous toxins and
gas; therefore, the condition is called gas gangrene.

Gangrene Symptoms
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Dry gangrene:
o The affected area becomes cold and numb.
o Initially, the affected area becomes red.
o Then, it develops a brown discoloration.
o Finally, it becomes black and shriveled.

Wet or moist gangrene:

o The affected area becomes swollen and decays.


o It is extremely painful.
o Local oozing occurs.
o It produces a foul-smelling odor.
o It becomes black.
o The affected person develops a fever.

Gas gangrene:
o The wound is infected.
o A brown-red or bloody discharge may ooze from the affected tissues.
o Gas produced by Clostridia may produce a crackling sensation when the affected
area is pressed.
o It becomes swollen.
o Pain in the affected area is severe.
o The affected person develops fever, increased heart rate, and rapid breathing if the
toxins spread into the bloodstream.

Medically Reviewed by a Doctor on 6/3/2014


Medical Author:
Ronald A Greenfield, MD
Coauthor:
Shehnaz Shaikh, MD
Medical Editor:
Melissa Conrad Stppler, MD, Chief Medical Editor

Symptoms of gangrene
The symptoms of gangrene vary depending on the underlying cause. The condition can
affect any part of the body, but typically starts in the toes, feet, fingers or hands.
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

In some cases, the affected limb may feel heavy and pressing the skin may produce a crackling
sound. These symptoms are caused by a build-up of gas under the skin.
If the area is infected, you may also have other signs related to the underyling infection, such as:

a high temperature (fever)

loss of appetite

rapid heartbeat and breathing

dizziness

shivering

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.
When to seek medical advice

The earlier treatment begins, the more successful it is likely to be. Contact your GP immediately
if you notice:

any of the symptoms of gangrene mentioned above

a persistent fever

a wound that is unusually slow to heal

If your GP is not available, call NHS 111 or your local out-of-hours service for advice.
When to seek emergency help

If bacteria from gangrene pass into your bloodstream, you could go into septic shock. This is a
life-threatening condition that happens when an infection causes your blood pressure to drop to a
dangerously low level.

Signs of septic shock include:

a rapid but weak pulse

dizziness when you stand up

a change in your mental state, such as confusion or disorientation

breathing difficulties

vomiting

diarrhoea

cold, clammy and pale skin

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