Gangrene (cont.)
How can gangrene be prevented?
If tissue obtains good oxygenation by adequate arterial blood flow and does not become infected, then both dry and wet gangrene can be prevented. Consequently, avoiding tobacco use and avoiding external trauma like frostbite can help prevent gangrene. Perhaps the best way to prevent gangrene, especially in developed countries, is to keep patients with diabetes under good glucose control and to have them do frequent examinations of their feet for any signs of cuts, infection, or redness. Patients with diabetic neuropathy (for
example, numbness in extremity) should do this daily.
If any wound or burn occurs, it should be treated immediately to prevent infection. This is especially important in people with diabetes, vasculitis, or a compromised immune system.
Some patients that notice coolness and redness of a local area (for example, toes, fingers) and get an angiogram that shows arterial blockage can have successful prevention of dry gangrene (and possibly wet gangrene) if the vascular surgeon can remove the clot or obstruction in the artery before local tissue dies.
What is the prognosis (outlook) for a patient with gangrene?
Patients with dry gangrene usually do well as long as they do not become infected. These patients lose some local function due to tissue loss and, if they have an ongoing disease like diabetes, may develop dry gangrene again. In general, patients recover with minimal residual problems if the tissue loss is small.
Patients with wet gangrene usually have a poorer prognosis than those with dry gangrene. Statistics for the U.S. suggest that the mortality (death) rate is about 6%-7% in patients hospitalized with gangrene. The mortality (death rate) increases to about 20%-25% if the patient becomes septic. If treatment is initiated early, only about 15%-20% of patients need some form of amputation (digits, limbs). Although the death rate has remained steady, the number of cases of gangrene has been increasing in the United States in recent years, possibly due to the increasing numbers of patients with diabetes and other diseases that affect the vascular system, but the data is not complete.
What are some additional sources of information on gangrene?
http://emedicine.medscape.com/article/217943-overview
http://emedicine.medscape.com/article/784690-overview
http://emedicine.medscape.com/article/438994-overview
http://www.ncbi.nlm.nih.gov/pubmed/10520915
- Gangrene refers to dead or dying body tissue(s) that occur because of inadequate blood supply.
- There are two major types of gangrene, wet gangrene and dry gangrene.
- Dry gangrene can result from conditions that reduce or block arterial blood flow such as diabetes, arteriosclerosis, and tobacco addiction as well as from trauma, frostbite, or injury.
- Wet gangrene can result from these causes as well but always includes infection. In some cases of wet gangrene, the initial cause is considered to be the infection.
- Treatment for all cases of gangrene usually involves surgery, medical treatment, supportive care, and occasionally, rehabilitation therapy.
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