What’s gangrene?

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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, although sometimes such necrosis can be found elsewhere. Once the gangrene has passed a certain point, amputation of the affected extremities is often the only solution, although medical technology has improved in solving the problem with less drastic actions. There are four main types: wet, dry, gas and internal. Of these, the internal form is relatively rare and 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 main forms.

Dry gangrene occurs when blood cannot reach a part of the body, so the tissue is no longer nourished. This condition can occur for a variety of reasons, such as a blood clot or poor circulation. Diabetics are particularly susceptible, as they often have circulation problems. The condition sometimes referred to as “diabetic foot” can, in the worst case, lead to serious problems that may require permanent amputation of the extremity. This type progresses more slowly than wet gangrene and, if caught early, can be reversed with surgery before the tissue becomes necrotic.

Wet gangrene can be caused by an abrupt cut off of blood flow to an area and a subsequent infection. This can be the result of severe cold, heat, or a serious injury. The classic image that most people have of this condition comes from old westerns or war movies where someone is shot and the untreated wound becomes infected and eventually becomes necrotic. Once the flesh has become necrotic, it must be removed from the body before the necrosis can spread, either through specific surgery or total amputation. In the past, the worms were sometimes used to devour necrotic flesh, and while this practice was frowned upon for a time, it’s starting to see a resurgence in many circles.

Gas gangrene is a specific type caused by a bacterial infection and the subsequent release of gases within the tissue. The most common bacterium responsible for this condition is Clostridium perfringens, which makes its way into the body from the surrounding environment through open wounds. Gas gangrene progresses very quickly and is almost always an emergency situation. Sometimes, antibiotics can be used in the early stages to fight the bacteria, at which point surgery can be used to remove the small pockets of necrotic flesh if the condition has been diagnosed 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 can be extremely painful and dangerous. If the condition is caught early, surgery or medications are usually used to remove the impediment to blood circulation. In later stages, more extensive surgery may be required.

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