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Gangrene is caused by death of tissues due to lack of blood supply. This may be caused by long term diseases that lead to damage to blood vessels like diabetes or due to blood vessel injury like in burns or injuries that give way to deeper tissue infections. These infections cause the part to swell up leading to occlusion of blood vessels.
Diagnosis of gangrene is based on history, physical examination and clinical and laboratory tests.
Medical history may indicate a long term health condition like diabetes, high blood cholesterol, injury in an accident or burn.
Physical examination shows discoloration of the affected area. In case of dry gangrene there is a dried, cool and black appearance of the affected limb.
Wet gangrene on the other hand leads to a swelling of the limb or the affected area. There is evidence of collection of foul smelling pus. (1-5)
Laboratory tests include;
Treatment of gangrene has three important aims (1-5):
Antibiotics are used to treat the infection. Oral antibiotic pills and intravenous antibiotics are used. Antibiotics may also be injected into the muscles.
Patients with gas gangrene and infections with Clostridium respond well to antibiotics like:
Some patients also require fluids and nutrients. Pain relievers are advised to reduce the pain associated with gangrene.
Surgical debridement involves removal of dead tissue that results from gangrene. This allows for the healthy surrounding tissue to heal and also prevents spread of infection.
Sometimes when the gangrene is severe, where the whole part like the toe or finger or limb is affected, surgical amputation may be the only option available.
Blood vessel surgery is of two types – bypass surgeries and angioplasty. Bypass surgeries create a diversion. The diversion redirects the flow of blood to bypass the obstruction.
Sometimes a process called angioplasty may be performed where a balloon like device placed into a blocked, artery and inflated to keep the artery open and patent.
Sometimes a novel therapy called Maggot therapy also known as biological therapy may be applied. There are certain maggots or fly larvae that are used for debridement to feed on dead and infected tissue.
The maggot leaves the healthy tissue unaffected. These maggots also release some substances that kill bacteria they also stimulate healing.
These maggots are specially bred in the laboratory with sterilized eggs. The maggots are put onto the wound and it is covered with a gauze and dressed. The dressing is cut off after a few days and the maggots are removed.
Hyperbaric oxygen (HBO) therapy is an alternative treatment. Since gangrene is caused by lack of oxygen this may help in healing.
The patient is placed within a special chamber and the chamber is filled with pressurised air and a plastic hood with pure oxygen. The plastic is placed over the gangrenous part. It causes the oxygen to dissolve into the blood and more oxygen can be delivered into the affected area to speed up healing.
HBO therapy prevents further damage by the bacteria and prevents production of toxins by the existing bacteria.
Prevention of gangrene involves keeping blood sugar and cholesterol under control. Patient is advised a healthy balanced diet, regular exercise and good foot and limb care.
Diabetics should get their feet checked by podiatrists at least once a year for prevention of foot ulcers that may turn into gangrene.
Patient should avoid walking barefoot, avoid harsh chemicals over foot and other extremities, keep feet clean and dry and avoid burns over the foot.
Stopping smoking can cut down risk of gangrene. Smoking leads to blockage of small arteries and loss of blood supply to fingers and toes known as peripheral arterial disease.
Similarly excessive alcohol leads to high cholesterol and arteriosclerosis and blockage of arteries.
Some patients also require fluids and nutrients. Pain relievers are advised to reduce the pain associated with gangrene.
Surgical debridement involves removal of dead tissue that results from gangrene. This allows for the healthy surrounding tissue to heal and also prevents spread of infection.
Sometimes when the gangrene is severe, where the whole part like the toe or finger or limb is affected, surgical amputation may be the only option available.
Blood vessel surgery is of two types – bypass surgeries and angioplasty. Bypass surgeries create a diversion. The diversion redirects the flow of blood to bypass the obstruction.
Sometimes a process called angioplasty may be performed where a balloon like device placed into a blocked, artery and inflated to keep the artery open and patent.
Sometimes a novel therapy called Maggot therapy also known as biological therapy may be applied. There are certain maggots or fly larvae that are used for debridement to feed on dead and infected tissue.
The maggot leaves the healthy tissue unaffected. These maggots also release some substances that kill bacteria they also stimulate healing.
These maggots are specially bred in the laboratory with sterilized eggs. The maggots are put onto the wound and it is covered with a gauze and dressed. The dressing is cut off after a few days and the maggots are removed.
Hyperbaric oxygen (HBO) therapy is an alternative treatment. Since gangrene is caused by lack of oxygen this may help in healing.
The patient is placed within a special chamber and the chamber is filled with pressurised air and a plastic hood with pure oxygen. The plastic is placed over the gangrenous part. It causes the oxygen to dissolve into the blood and more oxygen can be delivered into the affected area to speed up healing.
HBO therapy prevents further damage by the bacteria and prevents production of toxins by the existing bacteria.
Prevention of gangrene involves keeping blood sugar and cholesterol under control. Patient is advised a healthy balanced diet, regular exercise and good foot and limb care.
Diabetics should get their feet checked by podiatrists at least once a year for prevention of foot ulcers that may turn into gangrene.
Patient should avoid walking barefoot, avoid harsh chemicals over foot and other extremities, keep feet clean and dry and avoid burns over the foot.
Stopping smoking can cut down risk of gangrene. Smoking leads to blockage of small arteries and loss of blood supply to fingers and toes known as peripheral arterial disease.
Similarly excessive alcohol leads to high cholesterol and arteriosclerosis and blockage of arteries.