Gangrene - Medical Malpractice LawyersLEGAL HELPLINE: ☎ 855 804 7125
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Gangrene - Medical Malpractice
Gangrene is the death of a part of the body so that the tissue dies and turns black or green in color. It happens when there is no blood supply to the affected tissue and is caused by numerous things, including trauma, vascular disease and infection. Gangrene most commonly affects the fingers, toes, feet and hands.
There are two types of gangrene you can get. The first is dry gangrene, which is usually caused by poor blood flow via the arteries to an area of the body. It shows up gradually and the affected area simply turns black and sometimes falls off. It is common with atherosclerosis of the arteries and does not usually involve an infection. It is seen in diabetics, those with an elevated cholesterol, those who smoke and those with hereditary predisposition to atherosclerosis. Wet gangrene is a complication of an untreated infected body part. The area swells and cuts off the circulation of the area of the body so that it becomes gangrenous and is often infected. The gangrene can spread due to the bacteria infecting the body area. Gas gangrene is a type of wet gangrene that is caused by a specific organism, called Clostridium perfringens. When clostridium grows, it forms a toxin and gas beneath the skin so the skin is bubbly with excess gas. It is a serious problem.
The major causes of gangrene include a crush injury or severe burn to the affected area. Frostbite can cause gangrene. Diseases that affect the way the blood circulates such as diabetes, Raynaud's disease, and atherosclerosis can cause gangrene. Any kind of wound infection can cause gangrene, depending on the severity of the wound and on whether or not it is infected with Clostridium or not.
Symptoms of dry gangrene include reddened skin that gradually becomes brown and then black. The affected area feels cold to the touch and is numb. The body part shrivels up. In moist or wet gangrene, the affected area becomes decayed and swollen. It is painful to the touch and there is oozing of fluid and pus. It is usually foul-smelling and becomes black in color. There is often a fever. If it is gas gangrene, there is a brownish or bloody discharge from the wound and the skin may crackle from the gas forming beneath the wound. The wound is severely painful and swollen. The person develops fever and signs of sepsis.
The diagnosis of gangrene depends on a careful history and physical examination. Usually the gangrene can be identified just by examining the affected area. There is usually a history of diabetes or trauma to the affected area. Frostbite history can also be a factor or smoking history. Blood tests can be done and often show a high white blood cell count, especially in wet gangrene. You can sample the fluid draining from wet gangrene and do a gram stain for clostridium species or culture out the anaerobic organism. An x-ray can show bubbles beneath the skin in gas gangrene. CT scan or MRI scanning can be done to show the extent of the gas gangrene. In dry gangrene, an arteriogram can be done to show how well the blood flows to the affected area and exactly where the blockage is.
Gangrene is a serious illness that requires several kinds of treatment to heal. Antibiotics are used in wet and gas gangrene in order to kill of the bacteria that are causing the disease. The person needs to be hospitalized in order to receive IV antibiotics, which is a better choice than oral antibiotics. In dry gangrene, surgical intervention is the best option. The gangrenous area is removed up to a level where the circulation is good enough to heal the surgical wound. This is where the angiogram is helpful to know where the blockage is. In wet gangrene, doctors debride the damaged areas, trying to keep as much healthy tissue as possible. If any gangrenous tissue is left, it may spread and require another surgery. Antibiotics work better in wet gangrene than in dry gangrene because the circulation is better in wet gangrene and dry gangrene does not often involve a bacterial infection.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here