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What is Gangrene?

By Brendan McGuigan
Updated Mar 03, 2024
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Gangrene is a term used to describe a number of conditions in which tissue becomes necrotic and decays. Most often, this occurs in the extremities of the body, such as the feet or hands, though on occasion, such necrosis may be found elsewhere. Once gangrene has passed a certain point, amputation of the affected extremities is often the only solution, though medical technology has become better at solving the problem with less drastic actions. There are four major types: wet, dry, gas, and internal. Of these, the internal form is relatively rare and is often not listed, and gas gangrene is a special type of bacterial infection that is sometimes simply classified as wet gangrene. This leaves dry and wet as the two major forms.

Dry gangrene occurs when blood cannot reach a part of the body, so that the tissue is no longer fed. This condition may occur for a number of reasons, such as a blood clot or insufficient circulation. Diabetics are particularly susceptible, as they often have impaired circulation. The condition sometimes referred to as "diabetics foot" can, in the worst case, lead to severe problems that may require ultimate amputation of the extremity. This type progresses more slowly than wet gangrene, and if caught early on, it may be reversed through surgery before the tissue becomes necrotic.

Wet gangrene may be caused by an abrupt cessation of blood flow to an area and a subsequent infection. This may be the result of severe cold, heat, or a serious injury. The classic image most people have of this condition comes from old Western movies or war films in which someone is shot and the untreated wound becomes infected and eventually turns necrotic. Once the flesh has become necrotic, it must be removed from the body before the necrosis spreads, either through specific surgery or total amputation. In the past, maggots were sometimes used to devour the necrotic flesh, and while this practice was frowned upon for a period of time, it is beginning to see a resurgence in many quarters.

Gas gangrene is a specific type caused by a bacterial infection and the subsequent release of gas inside the tissue. The most common bacteria responsible for this condition is Clostridium perfringens, which make their way into the body from the surrounding environment through open wounds. Gas gangrene progresses extremely rapidly and is nearly always an emergency situation. Sometimes, antibiotics may be used in the early stages to fight off the bacteria, at which point surgery can be used to remove the small pockets of necrotic flesh if the condition was caught early enough.

Internal gangrene is the rarest type, in which blood circulation is impeded to various internal organs. Most often, this occurs in the appendix, gallbladder, or intestines, and it can be extremely painful and dangerous. If the condition is caught early on, surgery or medication is usually used to remove the impediment to blood circulation. In later stages, more extensive surgery may be necessary.

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Discussion Comments
By fBoyle — On Oct 31, 2012

@fify-- I think the best prevention is keeping your diabetes well managed and avoiding smoking.

Also, check your feet often in cold weather for any gangrene signs and symptoms so that you can seek treatment early.

By fify — On Oct 31, 2012

I have diabetes and I have a lot of trouble with my feet in winter. My feet are always cold and they also become numb in cold weather. I'm afraid that one day I will suffer from gangrene disease.

What can I do to help prevent this from occurring? I try to wear wool socks and thick shoes in winter. Is there anything more I can do?

By candyquilt — On Oct 30, 2012

@anon31258-- I believe that the difference between them is the bacterial infection that exists with wet gangrene.

Both dry and wet gangrene start out the same, they're caused by necrosis (tissue death). The difference is that in wet gangrene, the tissue also becomes infected.

Wet gangrene is a lot more dangerous than dry gangrene because of the infection.

By anon68579 — On Mar 03, 2010

the pathogenesis of one form of gangrene is still not clear to me, that is "how can wet gangrene be caused by sudden arterial occlusion?" if anyone has an answer to this please let me know.

By anon63721 — On Feb 03, 2010

What is the pathogenesis of different gangrene?

By anon31258 — On May 02, 2009

Why does the the wet gangrene appear wet while the dry gangrene appears dry? Do both these gangrenes share an initial common pathway of formation or do they have their own distinct pathogenesis?

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