What is the treatment for gangrene?
Treatment will depend on the type of gangrene, location, severity, and the patient's underlying medical conditions.
Most patients will have to have the dead tissue cut away (debridement), which may need to be repeated several times. Antibiotics will be needed for wet, gas, and Fournier's gangrene. Patients with severe gangrene, or those who do not respond to debridement and antibiotics, may require an amputation of the affected extremity. In addition, vascular surgery may be necessary to restore blood flow to the affected limb.
Hyperbaric oxygen therapy, where patients are exposed to increased oxygen concentrations under high pressure, is used at some medical centers with mixed results.
More controversial, and seldom used, is maggot therapy, where fly larvae are placed on the affected area to feed on the dead tissue.
What is the prognosis of gangrene?
The prognosis depends on the type of gangrene, the extent present at the time of diagnosis, and the patient's underlying illnesses.
Dry gangrene has a better prognosis than wet gangrene. Only 15%-20% of patients will need an amputation if treatment is started early. Approximately 6%-7% of patients admitted to the hospital with gangrene will die, but this number increases to 20%-25% if the infection has spread throughout the body (sepsis).
Is it possible to prevent gangrene?
The best way of preventing gangrene is by preventing and modifying the risk factors. Maintain a healthy lifestyle, including a healthy weight. Don't smoke or use drugs. If, despite these measures, you develop diabetes, follow your doctor's instructions to keep your blood sugar under good control.
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Falch, B.M., L. de Weerd, and A. Sundsfjord. "Maggot therapy in wound management." Tidsskr Nor Laegeforen 129.18 Sept. 24, 2009: 1864-1867.
Sroczyński, M., M. Sebastian, J. Rudnicki, A. Sebastian, and A.K. Agrawal. "A complex approach to the treatment of Fournier's gangrene." Adv Clin Exp Med 22.1 Jan.-Feb. 2013: 131-135.
Zacharias, N., et al. "Diagnosis of necrotizing soft tissue infections by computed tomography." Arch Surg 145.5 (2010): 452.