Ronald W. Smith, M.D.

Gangrene

gangreneI.      Definition:  Gangrene is the decay or death of tissue due to lack of blood supply to a certain area.   It most commonly occurs in extremities, such as toes.  Gangrene is medically classified as “moist” or “dry.”  Moist gangrene is commonly associated with a crushing injury or infection.  Dry gangrene is more common in the elderly, and is associated with a vascular disease.   As dry gangrene develops, the skin may become painful, cold, and discolored.  The tissue eventually turns black and has no feeling.  The skin bordering the affected tissue may be severely painful and red.   Moist gangrene looks wet with open sores.

II.      Cause:  Dry gangrene is commonly caused by vascular disease, such as arteriosclerosis, or blood clotting in which oxygenated blood is prevented from flowing through narrowed arteries.  Moist gangrene commonly occurs after an injury that cuts off blood supply and results in a bacterial infection.  Gangrene is often a complication of diabetes.  Diabetics are more susceptible to infection, which put them at a higher risk for developing gangrene.  Smoking is also known to be associated with poor circulation, putting smokers at higher risk of developing gangrene.

III.      Treatment and Prevention:  Patients with arteriosclerosis or diabetes should take steps to decrease the risk of developing gangrene.  Healthy foot care, including careful nail clipping and properly fitted shoes, is important in avoiding sores and infection.   Abrasions should be treated immediately.  Once gangrene develops, amputation of the dead tissue followed by antibiotics is a likely form of treatment.

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