Gangrene classification

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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

There are three main types of gangrene which include wet, dry, and gas gangrene. Sometimes, gangrene is also classified according to its site. ^[1]

Classification

There are three main types of gangrene which include wet, dry, and gas gangrene. Sometimes, gangrene is also classified according to its site. Table 1 summarizes the classification of gangrene.^[1]

**Table 1. Classification of Gangrene.**
Classification	Example	Description	Images

Based on Type	Dry Gangrene	Dry gangrene refers to a dehydrated necrotic tissue brought about by worsening ischemia distal to the occlusion of arteries. This is usually a worsening condition of peripheral artery disease.^[2]	Dry gangrene on the right foot of a patient with peripheral artery disease. (Image courtesy of Wikipedia)
	Wet Gangrene	This is an infection of a compromised tissue due to poor venous or arterial flow. Most cases of wet gangrene are seen in lower extremities, where pool of gravity leading to edema is most likely to happen. However, there are some instances that wet gangrene is seen in oral and genitourinary areas. People with diabetes are at high-risk to have this infection, which is attributed to hyperglycemia and poor wound healing.^[3]	Wet gangrene seen on a patient with diabetes and is suffering with severe infection and loss of toes (Image courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)
	Gas Gangrene	Gas gangrene is a bacterial infection that produces gas within tissues. It is a deadly form of gangrene usually caused by Clostridium perfringens bacteria. Infection spreads rapidly as the gases produced by bacteria expand and infiltrate healthy tissue in the vicinity. Because of its ability to quickly spread to surrounding tissues, gas gangrene should be treated as a medical emergency. Gas gangrene can cause necrosis, gas production, and sepsis. Progression to toxemia and shock is often very rapid.	Gas gangrene on the right leg and pelvis of a patient with palpable crepitus, swelling, bullae, and discoloration. (Image courtesy of Wikipedia)
Based on Site	Gangrene of the skull
	Gangrene of the face	Noma is the term used to refer to the gangrene of the face.
	Gangrene of the jaw
	Gangrene of the extremities
	Gangrene of the ribs
	Gangrene of the skin	Necrotizing fasciitis affects the deeper layers of the skin.
	Gangrene of the genitals	Fournier gangrene usually affects the male genitals.