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Gangrene

Medical Author: Charles P. Davis, MD, PhD
Medical Editor: Melissa Conrad Stöppler, MD

What is gangrene?

Gangrene is a term that describes dead or dying body tissue(s) that occur because the local blood supply to the tissue is either lost or is inadequate to keep the tissue alive. Gangrene has been recognized as a localized area of tissue death since ancient times. The Greeks used the term gangraina to describe putrefaction (death) of tissue. Although many laypeople associate the term gangrene with a bacterial infection, the medical use of the term includes any cause that compromises the blood supply that results in tissue death. Consequently, a person can be diagnosed with gangrene but does not have to be "infected."

There are two major types of gangrene referred to as dry and wet. Many cases of dry gangrene are not infected. All cases of wet gangrene are considered to be infected, almost always by bacteria. The most common sites for both wet and dry gangrene to occur are the digits (fingers and toes) and other extremities (hands, arms, feet, and legs).

What is the difference between wet and dry gangrene?

Wet (also sometimes termed "moist") gangrene is the most dangerous type of gangrene because if it is left untreated, the patient usually develops sepsis and dies within a few hours or days. Wet gangrene results from an untreated (or inadequately treated) infection in the body where the local blood supply has been reduced or stopped by tissue swelling, gas production in tissue, bacterial toxins, or all of these factors in combination. Additionally, conditions that compromise the blood flow such as burns or vascular trauma (for example, a knife wound that cuts off arterial flow) can occur first. Then the locally compromised area becomes infected, which can result in wet gangrene. Wet gangrene is the type that is most commonly thought of when the term gangrene is used. Wet gangrene often produces an oozing fluid or pus, hence the term "wet."

Dry gangrene, if it does not become infected and progress to wet gangrene, usually does not cause sepsis or cause the patient to die. However, it can result in local tissue death with the tissue eventually being sloughed off. Usually, the progression of dry gangrene is slower (days to months) than wet gangrene because the vascular compromise slowly develops due to the progression of diseases that can result in local arterial blockage over time. There are many diseases that may lead to dry gangrene; the most common are diabetes, arteriosclerosis, and tobacco addiction (smoking). Infrequently, dry gangrene can occur quickly, over a few hours to days, when a rapid arterial blockage occurs (for example, arterial blood clot in the blood suddenly occludes a small artery to a toe). Dry gangrene often produces cool, dry, and discolored appendages (sometimes termed "mummified") with no oozing fluid or pus, hence the term "dry."



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Gangrene

What is diabetes?

Diabetes mellitus is a group of metabolic diseases characterized by high blood sugar (glucose) levels, that result from defects in insulin secretion, or action, or both. Diabetes mellitus, commonly referred to as diabetes (as it will be in this article) was first identified as a disease associated with "sweet urine," and excessive muscle loss in the ancient world. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the urine, hence the term sweet urine.

Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level. In patients with diabetes, the absence or insufficient production of insulin causes hyperglycemia. Diabetes is a chronic medical condition, meaning that alt...

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