Gangrene is a life-threatening infectious condition. It mainly affects the limbs and in the past it was a feared and widespread complication of war wounds. In modern times, we meet with gangrene cases in patients with atherosclerosis and diabetes.
The gangrene means necrosis of body tissues because of insufficient blood and oxygen supply accompanied with bacterial infection caused by anaerobic bacteria. Anaerobic bacteria do not tolerate oxygen and non-oxygenated tissues are a great place for their life and proliferation. War wounds are ideal for gangrene occurrence due to combination of a deeper wound (stab, slash, gunshot, etc.), frequent damage of local blood vessels and insufficient hygiene.
Nowadays, the main causative factor of gangrene is combination of diabetes and atherosclerosis. Atherosclerosis causes narrowing of the arteries and this leads to development of peripheral vascular disease of the lower extremities with oxygen and nutrient deficiency. The diabetes causes slow wound healing and makes the patients prone to bacterial infections and diabetic foot occurrence. In addition, the gangrene may also complicate severe damage done to tissues by a physical factor such as in burns or frostbite.
Types of gangrene
In dry gangrene the tissues of limbs gradually succumb to necrosis without a significant presence of bacteria. The peripheral tissues turn black and wither.
Wet gangrene occurs when bacteria infect the tissues. Affected body parts smell terribly and turn into smelly greenish matter.
This type of gangrene is related to presence of bacterial group known as clostridium. Clostridium is a dangerous anaerobic bacterium, which damages affected tissues and produces a range of gases and toxic substances. The infected tissue is swollen, purulent and by palpation we feel the gas bubbles. This form of gangrene is really deadly.
Gangrene can be prevented by proper treatment of patients with peripheral vascular disease and patients with high risk of development of diabetic foot. The patient must avoid any injury and any already present wound must be cautiously cleansed and treated. Suspected wound infections should be treated by antibiotics.
Any case of gangrene should be treated aggressively. The patient should be hospitalized, intravenously hydrated and antibiotics should be administered in high doses. The affected tissues are treated surgically. The surgeon removes dead tissues and separates them from the healthy ones. Any present abscesses must be cut open and the pus drained. In some cases it is necessary to perform a total amputation of the affected limb. The therapy of anaerobic infections can be successfully supported by usage of the so-called hyperbaric oxygen therapy. The patient is put into a special closed environment with a high concentration of oxygen. The bacteria do not tolerate oxygen and hyperbaric environment suppresses their growth and proliferation.