gangrene Alternative Names
Gangrene is the death of living cells or tissues of the body.
What is going on in the body?
Gangrene occurs when the blood supply to part of the body is cut off. This depletes the tissues of oxygen and they begin to die. Gangrene usually affects the extremities, such as the toes, feet, legs, fingers, hands, and arms. It may also occur in other parts of the body, including the abdomen or intestines. Gangrene usually occurs after trauma or surgery. Usually gangrene begins 24 hours to 3 days after trauma but may occur anywhere from 3 hours to 6 weeks later. As the tissue begins to die, carbon monoxide and hydrogen gases are released, causing bubbling around the tissue.
There are two types of gangrene:
What are the signs and symptoms of the infection?
- dry gangrene, a condition in which the tissues dry and slough off because the blood vessels are no longer supplying blood to the area
- wet or gas gangrene, which is usually caused from a bacterial infection of a wound
Symptoms of gangrene may include:
What are the causes and risks of the infection?
- a crackling or rubbing sensation under the skin
- severe pain and swelling at the site of injury
- numbness at the site of the infection
- discolouration of the skin, often starting as white and eventually becoming brownish-reddish or black colour
- dark and red or black muscles and bones if the skin breaks open
- frothy, watery, foul smelling discharge
- fever, with a temperature around 38 degrees Celsius
- pale skin
- decreased activity
- rapid heart beat
Causes of gangrene include:
What can be done to prevent the infection?
- a blockage of blood to an organ or tissue
- surgery causing tissue damage
- trauma or injury, such as frostbite, boils, crush injuries, and severe burns, that destroys tissues in the body
- infection of wounds, especially deep wounds
- certain diseases that affect circulation, including arteriosclerosis, diabetes, and Raynaud's disease
- blood clots, such as a deep venous thrombosis
- a ruptured appendix caused by appendicitis
- an intestinal hernia
- smoking and drinking alcohol
A person may be able to prevent gangrene in some instances by: How is the infection diagnosed?
The doctor will start to diagnose gangrene based on a person's medical history and physical examination. Other special tests and scans may be ordered including:
What are the long-term effects of the infection?
- x-rays to examine the tissues for gas bubbles
- blood tests and blood cultures
- tissues cultures or cultures of any drainage from the wound
Long term effects of gangrene may include:
What are the risks to others?
- permanent death of the tissues in the area affected
- amputation of the affected limb or removal of the affected organ
- sepsis, or blood poisoning
- death, especially with gangrene of the abdomen or the bowels, if gangrene goes untreated
Gangrene poses no risk to others.
What are the treatments for the infection?
Gangrene must be treated right away. If the tissues or muscles show any signs of swelling, intravenous antibiotics will be needed to treat the infection. Blood thinners to prevent blood clots may also be prescribed. Analgesics are prescribed to treat discomfort.
A person may need to be in the hospital to receive intravenous antibiotics, intravenous fluids, and monitoring of the gangrene. Bed rest is essential in early stages of treatment. Often the affected tissues, organ, or limbs must be amputated so that infection doesn't spread. Physiotherapy may also be needed, especially if amputation occurred.
What are the side effects of the treatments?
Side effects depend on the treatments used. For instance, antibiotics may cause allergic reactions and stomach upset. Surgery carries a risk of bleeding, infection, and allergic reactions to anaesthesia.
What happens after treatment for the infection?
Sometimes no further treatment is needed once the cause of the gangrene is identified and corrected. For more serious disease or injury, treatment may continue and a person may have further instructions to follow. If a person had surgery, he or she may need to take it easy for several days to several weeks and need follow up care. Physiotherapy and daily strengthening exercises may be needed.
How is the infection monitored?
Any new or worsening symptoms should be reported to the doctor.
Author: Eileen McLaughlin, RN, BSN
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request