Have you ever heard someone say they have 'gangrene'? You've probably heard this word in connection with a wound that has become very infected, or a leg or arm that has turned black. This is a very dangerous medical emergency that requires immediate treatment. Simply put, gangrene is when blood flow to a part of your body stops, causing the tissue in that area to die. Although it can happen anywhere, it most often starts in the fingers or toes. Today, we're going to talk about this in a simple, easy-to-understand way.
What exactly is gangrene?
Imagine that every cell and tissue in our body needs oxygen and nutrients to survive. These things are carried by the blood. What happens if the blood supply to a part of the body stops for some reason? Just like a tree dies without water, the tissue in that part also starts to die. That is what we call gangrene .
The important thing is that gangrene is always tissue death. However, not all gangrene is necessarily caused by infection. Sometimes, the blood supply can stop and the tissue can die, without any bacterial infection. However, if a bacterial infection joins the dead tissue, the situation becomes even worse. If not treated promptly, this condition can cause very serious complications, even death.
What are the main types of gangrene?
Gangrene can be divided into several main types. Each of them is a little different from the other. Let's take a look at what they are.
| Type of gangrene | Simple explanation |
|---|---|
| Dry Gangrene | This is simply a case of blood clots. There is no bacterial infection. The affected skin becomes dry, scaly, and black. No pus-filled blisters are seen. This is more common in people with conditions such as diabetes and atherosclerosis, which can lead to blockage of blood vessels due to high cholesterol. |
| Wet Gangrene | This is a severe bacterial infection that occurs when blood flow stops. True to its name, the skin becomes swollen, blisters, and oozes a pus-like fluid. That's why it's called 'wet'. It has a very bad odor. This type of infection spreads very quickly to other healthy tissues. |
| Gas Gangrene | This is a very dangerous and fast-spreading type. Some types of bacteria that enter the body through deep wounds produce gas inside the muscles. This destroys the tissue. If you press on the affected skin, you will hear a 'chiri chiri' sound as if air bubbles are bursting underneath. This can be life-threatening within a few hours. |
| Fournier's Gangrene | This is a very rare, serious bacterial infection. It occurs in the genitals and surrounding areas. It is more common in men. |
| Internal Gangrene | This occurs when blood flow to an organ inside the body is cut off. For example, this condition can occur in the gallbladder, intestines, or appendix. |
What are the symptoms of gangrene?
The symptoms of gangrene can vary slightly depending on the type. But there are some common signs that you can see. If you have any of these, you should see a doctor immediately.
- Skin discoloration: The skin in the affected area may first turn pale, then red, purple, green, and finally black.
- Severe pain: Initially, there may be unbearable pain in the area, and then there may be complete loss of sensation as the tissue dies.
- Swelling and numbness: The affected area may feel swollen and numb.
- Cold skin: Compared to other healthy areas, gangrene feels very cold to the touch.
- Foul-smelling pus: In wet gangrene, blisters may form and ooze foul-smelling pus or blood-tinged fluid.
- 'Cherry-Cherry' sound: In gas gangrene, when the skin is pressed on top, a sound is heard as if air bubbles are bursting underneath.
- Common symptoms:Symptoms such as fever, lethargy, rapid heartbeat, increased breathing rate, and mental confusion may also occur, especially when the infection spreads throughout the body (sepsis).
The most important thing is the change in skin color. At first, it becomes pale due to reduced blood flow, then it turns red, gradually turns brown, and finally turns purple or green-black. It may be difficult for someone with dark skin to recognize these color changes at first.
What are the causes and risk factors for gangrene?
The primary cause of gangrene is the blockage of blood flow to a part of the body. There are several main causes and risk factors that contribute to this.
Causes of blood flow obstruction:
- Blood vessel diseases: Cholesterol deposits in the blood vessels and narrowing them (Peripheral Artery Disease) is the main cause of dry gangrene.
- Severe injuries: If a major injury occurs, such as a car accident or being caught in machinery, and the blood vessels are damaged.
- Complications from surgery: Although very rare, blood flow can be disrupted after some surgeries.
- Infections: An untreated bacterial infection can cause tissue swelling and bleeding.
People who increase their risk of developing gangrene:
- Patients with Diabetes: Diabetes is very common in our country. Diabetes damages the blood vessels and nerves. As a result, the sensation in the legs is reduced, even a small wound goes unnoticed, and there is a high chance that it will not heal quickly and will become infected and develop gangrene. People with diabetes should take great care of their feet.
- Smokers: Smoking damages blood vessels and causes them to narrow.
- Obesity: Obesity increases the risk of gangrene, as it can lead to diseases such as diabetes and high blood pressure.
- People with weakened immune systems: People with HIV/AIDS, cancer patients, and those undergoing chemotherapy have a reduced ability to fight infections.
- Raynaud's syndrome: A condition in which blood flow to the fingers and toes temporarily stops when exposed to cold.
How is gangrene diagnosed and treated?
If you think you have symptoms of gangrene, you should see a doctor or go to a hospital's Emergency Department (ETU) without delay.
The doctor will examine you, ask about your medical history, and order some tests if necessary.
- Blood tests: Check for infection and white blood cell count.
- Bacterial culture: Identify the bacteria causing the infection and prescribe the most appropriate antibiotic.
- Imaging tests: An X-ray, CT scan, or MRI scan can look for tissue damage and gas.
- Blood flow testing: Special tests to check for blockages in the blood vessels.
Treatment methods
There are three main goals in treating gangrene: removing dead tissue, controlling infection, and restoring blood flow.
1. Antibiotics: If there is a bacterial infection, strong antibiotics are given intravenously to control it.
2. Debridement: This is a surgical procedure. Gangrenous tissue does not heal. Therefore, it must be surgically removed. If not, the infection will spread to healthy tissue.
3. Surgery to restore blood flow: Surgery can be performed to widen a blocked blood vessel (Angioplasty) or to create a new path to bypass it (Bypass surgery).
4. Hyperbaric Oxygen Therapy (HBOT): In this, the patient is placed in a hyperbaric chamber and made to breathe 100% pure oxygen. This greatly increases the oxygen level in the blood, helping the tissues heal.
5. Amputation: In severe cases, when other treatments fail, the only way to save the patient's life is to surgically remove the affected limb, such as a finger, toe, or hand. This is considered a last resort by doctors.
When should you seek emergency medical attention?
Gangrene is a medical emergency. If you have the following symptoms, go to a hospital's Emergency Department (ETU) immediately.
- If your skin has turned black, lost sensation, become cold, or swollen somewhere on your body.
- If a wound that doesn't heal has a bad odor or is oozing pus.
- If you have a fever with sudden severe pain.
If you have these symptoms along with difficulty breathing, a very fast heartbeat, mental confusion, and cold sweats, it means that the infection has spread throughout the body and is developing into a life-threatening condition called septic shock . Therefore, immediate treatment is required.
Take-Home Message
- Gangrene is the death of tissue due to lack of blood flow to a part of the body. This is a very dangerous and urgent medical condition.
- The main symptoms are skin discoloration (especially darkening), severe pain, swelling, and foul-smelling pus. If you notice these, don't delay.
- People with diabetes are at higher risk of developing gangrene, so it's important to follow your doctor's instructions and take special care of your feet.
- Time is of the essence when treating gangrene. The sooner treatment begins, the better the results.
- If you have any suspicions about gangrene, do not speculate and see your doctor immediately.
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