Just the Facts: Gangrene & Feet

Although it’s an uncommon condition, it’s important to know about gangrene because it has the potential to affect many different people. Of course, gangrene is generally not something that will “just spring up.” But there are risk factors and warning signs and knowing these will help you avoid complications.

What is gangrene?

 This is a serious and potentially life-threatening ailment.

How does gangrene happen?

Gangrene arises from restricted blood flow, usually to the lower extremities. The skin and underlying tissue are not receiving adequate amounts of oxygen and they slowly begin to necrotize (die). Gangrene has two primary causes—existing vascular conditions or infection.

Gangrene from vascular issues

A lack of blood to the tissues in your legs and feet can develop due to many different pre-existing conditions. This includes diabetes, atherosclerosis (blood vessel disease), vascular disease, Reynaud’s disease, smoking, obesity, injury, immunosuppression, and certain medications that affect circulation. This leads to a form of gangrene called Dry Gangrene.

What is dry gangrene?

The most common type of gangrene is dry gangrene. This type of gangrene takes days or even months to develop and generally stems from a preexisting vascular condition. Signs of dry gangrene vary with severity and location but generally start with a cool and numb feeling in the affected area. Skin will change from healthy to brown, blue, or black accompanied by evidence of excessive dryness and shrinkage.  

Eventually, the body will slough off the affected area (meaning the tissue will fall off completely). While fatalities from dry gangrene are rare, it is still important to get treatment immediately because, as tissue death progresses, more extreme measures may have to be taken to correct it. It is also not uncommon for dry gangrene areas to become infected and progress to wet gangrene, which is much worse.

Gangrene from infection

Gangrene resulting from infection usually occurs after a bad injury that isn’t treated properly or from a wound following a medical procedure or as a complication of another injury such as a burn or frostbite. Gangrene caused by infection is often termed Wet Gangrene.

What is wet gangrene?

Wet or moist gangrene is very dangerous and can lead to internal infections such as sepsis which often causes patients to die within a few days. Wet gangrene is caused by a wound or injury which has become infected but has been poorly treated. Tissue death in wet gangrene occurs when swelling or injury disrupts blood flow. The buildup of toxins or gasses within surrounding tissue can also reduce blood flow and contribute to further infection and tissue death.

Aching pain and swelling in the area of a wound or injury are early symptoms of wet gangrene. You may also develop a foul-smelling discharge or pus in the area. Often the dying tissue takes on a moist, black appearance. Infection can also lead to gas buildup inside the body tissues, so you may feel a crackling under the skin where gas is trapped.

How is gangrene diagnosed?

First, you must recognize the possible signs of gangrene and get yourself to emergency medical care. If dry gangrene is suspected, your doctor will perform an angiography, which will show how much blood is flowing in the affected tissues. For wet gangrene, blood cultures are used to determine the type of infection, and MRIs are used to show the extent of damaged tissue or the spread of gas.

How is gangrene treated?

Early recognition is critical to reducing the severity of treatment needed. In many cases, removal (debridement or amputation) of the affected area is often necessary along with antibiotic treatment. Wounds can also be treated with hyperbaric oxygen treatment in conjunction with other methods.

How do I avoid gangrene?

This all sounds terrible, but avoiding gangrene is generally easy. For diabetics, this means maintaining steady glucose levels and checking your feet regularly. This should be a daily activity for those with any vascular condition affecting the feet. If you have any injury to an extremity (such as your toes), especially if it is a burn or cut, get treatment right away. Preventing infection is an important step to preventing gangrene.

In short, as I have said many times before, just pay attention to your feet. If you suspect that you have signs of gangrene, contact our doctors immediately to make an appointment. Early diagnosis and treatment are important to reduce complications and speed healing time.

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