Dec 31, 2008

Gangrene

Gangrene
Definition
Gangrene is the death of an organ or body tissue. When the blood supply is cut off, the tissue doesn't get enough oxygen; it begins to die. If the gangrene is widespread, generalized shock may occur.
There are three main types:
Dry gangrene - The lack of blood supply causes the tissue to dry up and slough off.
Wet gangrene - The tissue becomes moist and decomposes. Wet gangrene usually occurs when the tissue is infected with bacteria.
Gas gangrene - This is a particular type of bacteria (Clostridia) that produces gas bubbles in the tissue.
Causes
Causes of gangrene include:
• Infection, especially after surgery or injury
• Diabetes
• Any condition that may block the blood flow to the tissues (such as atherosclerosis)
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for gangrene include:
• Smoking
• Drinking alcohol
• Traumatic injury, especially crushing injuries
• Wound infection after surgery
• Frostbite
• Burns
• Atherosclerosis
• Diabetes
• Raynaud's disease
• Blood clots
• Ruptured appendix
• Hernia
• Intravenous drug use
Symptoms
Symptoms of gangrene may include:
• Swelling
• Pain, followed by numbness when the tissue is dead
• Sloughing off of skin
• Color changes, ranging from white, to red, to black
• Shiny appearance to skin
• Frothy, clear, watery discharge
• Fever and chills
• Nausea and vomiting
Gangrene of the Foot

Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam.
Tests may include:
• Blood Tests
• Tests of the discharge and tissue from the gangrenous area
• X-rays of the area
• CT Scan – a type of x-ray that uses a computer to make pictures of the inside of the body
• MRI Scan – a test that uses magnetic waves to make pictures of the inside of the body
Treatment
Treatment of gangrene includes the following:
Antibiotics – These medications are given in a very potent form, through an IV.
Blood thinners – These drugs are given to prevent blood clots.
Debridement – This is a surgical procedure to cut away dead and dying tissue. It is done to try to avoid the spread of gangrene.
Amputation – If an entire toe, finger, hand, foot, leg, or arm is severely affected by gangrene, this body part may need to be removed.
Hyperbaric oxygen treatment – This therapy involves exposing the affected tissue to oxygen at high pressure.
Prevention
To help prevent gangrene:
• Patients with diabetes need to take very good care of their hands and feet.
• Surgical patients may be given antibiotics to help prevent infection (especially after intestinal surgery).