Published: 18 Jun 2025

ICD9: 040.0      ICD10: A48.0      ICD11: MC85

Gangrene is the death of body tissue due to a loss of blood supply.
It can occur anywhere in the body, but it most commonly affects the extremities, such as the toes, fingers, and limbs.

Here's a breakdown of key aspects of gangrene:

Causes:

Reduced or Blocked Blood Flow: This is the primary cause. Conditions that can lead to this include:
Atherosclerosis (Hardening of the Arteries): Plaque buildup narrows arteries, reducing blood flow.
Blood Clots: Can block blood vessels, cutting off supply to an area.
Diabetes: High blood sugar levels can damage blood vessels over time, leading to poor circulation.
Peripheral Artery Disease (PAD): Similar to atherosclerosis, but specifically affects arteries in the limbs.
Trauma: Severe injuries, burns, or frostbite can damage blood vessels and tissues directly.
Surgery: In rare cases, surgical complications can disrupt blood flow.
Raynaud's Phenomenon: Causes blood vessels to narrow in response to cold or stress.

Infection: Bacterial infections can also contribute to gangrene, especially when blood supply is already compromised. Some bacteria release toxins that damage tissues.

Types of Gangrene:

Dry Gangrene: Characterized by dry, shriveled, and darkened (often black or bluish) skin. It typically occurs when blood supply is gradually cut off. Often seen in people with diabetes or atherosclerosis. Infection is usually not present initially, but can develop.

Wet Gangrene: Occurs when there's a bacterial infection in the affected tissue. The tissue becomes swollen, blistered, and moist. It can spread rapidly and is considered a medical emergency. Often has a foul odor. Can be caused by burns, crushing injuries, or diabetic foot ulcers.

Gas Gangrene: A particularly dangerous and rapidly spreading form of wet gangrene caused by bacteria that produce gas within the infected tissue (primarily *Clostridium perfringens*). The gas can create bubbles in the tissue (crepitus) that you can feel under the skin. Often occurs after trauma or surgery. Extremely painful and can be fatal.

Internal Gangrene: Affects internal organs, such as the gallbladder, intestines, or appendix. Occurs when blood flow to an organ is blocked. Can be difficult to diagnose and requires immediate surgical intervention.

Fournier's Gangrene: A rare but life-threatening type of gangrene that affects the genitals and perineum (the area between the anus and scrotum or vulva). More common in men than women.

Symptoms:

Skin Discoloration: Ranges from pale to blue, black, bronze, or red, depending on the type and stage.
Pain: Can be severe initially, but the affected area may become numb as nerve function is lost.
Swelling: Especially in wet gangrene.
Blisters: Often filled with fluid.
Foul Odor: A characteristic of wet and gas gangrene.
Thin, Shiny Skin: Can indicate poor circulation.
Coldness or Numbness: In the affected area.
Crepitus: A crackling sensation under the skin due to gas in the tissues (gas gangrene).
General Symptoms: Fever, malaise (a general feeling of discomfort), and sepsis (a life-threatening response to infection).

Diagnosis:

Physical Examination: The doctor will examine the affected area and assess your overall health.
Blood Tests: To look for signs of infection and assess kidney and liver function.
Imaging Tests:
X-rays: To check for gas in the tissues.
CT Scans or MRIs: To visualize the extent of tissue damage and identify any underlying blockages in blood vessels.
Arteriography: An X-ray of the arteries after injecting dye to highlight blood flow.
Tissue Culture: To identify the bacteria causing the infection.
Surgical Exploration: Sometimes necessary to determine the extent of the gangrene.

Treatment:

Gangrene treatment is aimed at:

Removing the Dead Tissue (Debridement):
Surgical Debridement: Cutting away the dead tissue. This is often necessary to prevent the spread of infection.
Enzymatic Debridement: Using enzymes to dissolve dead tissue.
Maggot Therapy: In some cases, sterile maggots are used to clean away dead tissue.
Treating the Infection:
Antibiotics: To fight the bacterial infection (especially important for wet and gas gangrene).
Restoring Blood Flow:
Vascular Surgery: Bypass surgery to reroute blood flow around blocked arteries.
Angioplasty: Using a balloon to widen narrowed arteries.
Hyperbaric Oxygen Therapy: Involves breathing pure oxygen in a pressurized chamber. This can help to kill anaerobic bacteria (like those that cause gas gangrene) and promote wound healing.
Amputation: In severe cases, amputation of the affected limb or body part may be necessary to prevent the spread of infection and save the person's life.
Supportive Care: Pain management, fluid replacement, and nutritional support.

Prevention:

Manage Underlying Conditions: Control diabetes, high blood pressure, and high cholesterol.
Quit Smoking: Smoking damages blood vessels.
Maintain a Healthy Weight: Obesity can contribute to poor circulation.
Take Care of Your Feet: Especially if you have diabetes or poor circulation. Inspect your feet daily, wear comfortable shoes, and avoid walking barefoot.
Treat Wounds Promptly: Clean and bandage any cuts, scrapes, or sores.
Protect Yourself from Cold: Prevent frostbite by wearing appropriate clothing in cold weather.

Complications:

Sepsis: A life-threatening condition caused by the spread of infection throughout the body.
Shock: A dangerous drop in blood pressure that can lead to organ damage.
Organ Failure: Can occur as a result of sepsis or shock.
Death: Gangrene can be fatal if left untreated.

In Summary:

Gangrene is a serious condition that requires prompt medical attention. Early diagnosis and treatment are essential to prevent complications and improve the chances of survival. If you suspect you have gangrene, seek immediate medical care.