Gangrene

Gangrene
Other names	Gangrenous necrosis
Dry gangrene affecting the toes as a result of peripheral artery disease
Specialty	Infectious disease, surgery, podiatry
Symptoms	Change in skin color to red or black, numbness, pain, skin breakdown, coolness[1]
Complications	Sepsis, amputation[1][2]
Types	Dry, wet, gas, internal, necrotizing fasciitis[3]
Risk factors	Diabetes, peripheral arterial disease, smoking, major trauma, alcoholism, plague, HIV/AIDS, frostbite, Raynaud's syndrome[3][4]
Diagnostic method	Based on symptom, With medical imaging used to identify the underlying cause.
Treatment	Depends on underlying cause[5]
Prognosis	Variable
Frequency	Unknown[2]

Gangrene is a type of tissue death caused by a lack of blood supply.^[4] The feet and hands are most commonly affected.^[1] If the gangrene is caused by an infectious agent, it may present with a fever or sepsis.^[1]

Symptoms may include:^[1]

• a change in skin color to red or black
• numbness
• swelling
• pain
• skin breakdown
• coolness

Common risk factors include, but are not limited to, diabetes, peripheral arterial disease, smoking, major trauma, alcoholism, HIV/AIDS, frostbite, influenza, dengue fever, malaria, chickenpox, plague, hypernatremia, radiation injuries, meningococcal disease, Group B streptococcal infection and Raynaud's syndrome.^[3][4]

It can be classified as dry gangrene, wet gangrene, gas gangrene, internal gangrene, and necrotizing fasciitis.^[3] The diagnosis of gangrene is based on history and physical examination and supported by tests such as medical imaging.^[6]

Main classifications:^[7]

• Dry Gangrene: A type of coagulative necrosis that is caused by lack of blood supply leading to ischemia and death of the tissue.
• Wet Gangrene: A type of liquefactive necrosis where the death of tissue due to lack of blood supply simultaneously occurring with a bacterial infection.
• Gas Gangrene: A type of liquefactive necrosis where the superimposed bacterial infection is caused by gas-producing bacteria such as some of the Clostridia.

Treatment may involve surgery to remove the dead tissue, antibiotics to treat any infection, and efforts to address the underlying cause.^[5] Surgical efforts may include debridement, amputation, or the use of maggot therapy.^[5] Efforts to treat the underlying cause may include operative procedures such as bypass surgery or endovascular interventions such as stenting or angioplasty.^[5] In certain cases, hyperbaric oxygen therapy may be useful.^[5] How commonly the condition occurs is unknown.^[2]