Gangrene overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Edzel Lorraine Co, D.M.D., M.D.
Overview
Gangrene is a complication of necrosis (i.e., cell death) characterized by the decay of body tissues, which become black and malodorous. It is caused by infection or ischemia, such as from thrombosis (blocked blood vessel). It is usually the result of critically insufficient blood supply (e.g., peripheral vascular disease) and is often associated with diabetes and long-term smoking. This condition is most common in the lower extremities. The best treatment for gangrene is revascularization (i.e., restoration of blood flow) of the affected organ, which can reverse some of the effects of necrosis and allow healing. Other treatments include debridement and surgical amputation. The method of treatment is generally determined depending on location of affected tissue and extent of tissue loss. Gangrene may appear as one effect of foot binding.
Historical Perspective
The etymology of gangrene derives from the Latin word "gangraena" and from the Greek gangraina (γάγγραινα), which means "putrefaction of tissues".
Classification
Three main types of gangrene in clude wet, dry and gas gangrene. Sometimes it can be classified according to its site.
Causes
Gangrene happens when a body part loses its blood supply. This may happen from injury, an infection, or other causes.
Treatment
Medical Therapy
As early as 1028, when antibiotics had not yet been discovered, fly maggots were commonly used to treat chronic wounds or ulcers to prevent or arrest necrotic spread, as some species of maggots consume only dead flesh, leaving nearby living tissue unaffected. This practice largely died out after the introduction of antibiotics and enzyme to the range of treatments for wounds. Recently, however, maggot therapy has regained some credibility and is sometimes employed with great efficacy in cases of chronic tissue necrosis.
Surgery
In modern times treatment is usually surgical debridement, and excision with amputation is necessary in many cases. Antibiotics alone are not effective because they do not penetrate ischemic muscles sufficiently.
Primary Prevention
Gangrene may be prevented if it is treated before the tissue damage is irreversible. Wounds should be treated properly and watched carefully for signs of infection (such as spreading redness, swelling, or drainage) or failure to heal.People with diabetes or blood vessel disease should routinely examine their feet for any signs of injury, infection, or change in skin color and seek care as needed.