Gangrene – The Dead Tissues!

April 30, 2021Articles1

Gangrene is death of body tissue due to a lack of blood flow or a serious bacterial infection. It commonly affects the arms and legs, including the toes and fingers, the areas farthest from your heart, but it can also occur in the muscles and in organs inside the body, such as the gallbladder.
The condition typically starts in a specific body part, such as leg, hand or internal organ. It can spread through your body and cause you to go into shock if left untreated.Shock is a condition marked by a variety of symptoms including low blood pressure. Shock can be life-threatening and is considered a medical emergency.

Gangrene is a medical emergency that could lead to amputations or death. Recognizing and treating the condition as fast as possible will improve your outlook.
Types-

There are two main types –
• Dry gangrene –
This is more common in people who have vascular disease, diabetes and autoimmune diseases. It usually affects your hands and feet. It happens when something- often, poor circulation – blocks blood flow to a certain area. As your tissue dries up, it changes color. It may be brown to purplish – blue to black.The tissue often falls off. Unlike with other types of gangrene, you typically don’t have an infection. But dry gangrene can lead to wet gangrene if it becomes infected.
• Wet gangrene –
This type almost always involves an infection. Burns or trauma in which a body part is crushed or squeezed can quickly cut off blood supply to the area, killing tissue and raising the odds of infection. The tissue swells and blisters, it is called wet because it causes pus. Infection from wet gangrene can spread swiftly around your body.
Types of Wet gangrene include –
▪︎Internal gangrene –
This is gangrene that affects your internal organs. It is usually related to an infected organ such as you appendix or colon.
▪︎Gas gangrene –
It is rare but especially dangerous. It happens when you get an infection deep inside your body, such as inside muscles or organs, usually because of trauma. Bacteria called clostridia release dangerous toxins or poisons, along with gas that can be trapped in your tissue. Your skin may become pale and gray and make a crackling sound when pressed. Without treatment, gas gangrene can be deadly within 48 hours.
▪︎Fournier’s gangrene –
It is a rare condition which is caused by an infection in your genital area. It affects men more often than women. If the infection gets into your bloodstream, a condition called sepsis, it can be life – threatening.
▪︎Progressive bacterial synergistic gangrene ( Meleney’s gangrene ) –
This type usually causes painful lesions on your skin 1-2 weeks after surgery or minor trauma. It is also rare.
Symptoms –

When gangrene affects your skin, signs and symptoms may include –
• Skin discoloration- ranging from pale to blue, pimple, black, bronze or red, depending on the the type of gangrene you have.
• Swelling
• Blisters
• Sudden severe pain followed by a feeling of numbness
• Thin, shiny skin or skin without hair
• Skin that feels cool or cold
If you have a type of gangrene that affects tissues beneath the surface of your skin, such as gas gangrene, you may also have a low -grade fever and generally feel unwell.
If the germs that caused the gangrene spread through your body, septic shock can occur. Sign and symptoms of septic shock include-
• Low blood pressure
• Fever
• Shortness of breath
• Rapid heart rate
• Lightheadedness
• Confusion
Causes-

• Lack of blood supply-
The common cause of either wet or dry gangrene is loss of an effective local blood supply to any tissue. Loss of the blood supply means titres are deprived of oxygen, thus causing the cells in the tissue to die. The most common causeof gangrene is tissue blood supply loss.
• Infection –
An untreated bacterial infection can cause gangrene.
• Traumatic injury-
Gunshot wounds or crushing injuries from car crashes can cause open wounds that let bacteria into the body.
Risk factors –

Any condition that affects your blood flow increases your chances of getting gangrene, including-
• Diabetes
• Narrowed arteries (atherosclerosis)
• Smoking
• Peripheral artery disease
• Trauma or serious injury
• Serious frostbite
• Obesity
• Raynaud’s phenomenon (a condition in which the blood vessels that supply your skin become narrowed)
• Weakened immune system
• Complication of COVID-19
Complications –

Gangrene can lead to serious complications if it’s not immediately treated. Bacteria can spread quickly to other tissues and organs. You may need to have a body part removed (amputated) to save your life.
Removal of infected tissue can lead to scarring or the need for reconstructive surgery.
Prevention –

• Care for your diabetes
• Lose weight
• Don’t use tobacco
• Help prevent infections
• Watch out when the temperature drops
Diagnosis-
Tests used to help make a diagnosis of gangrene include –
• Blood tests –
An abnormally high white blood cell count is usually a sign of infection.
• Fluid or tissue culture –
Tests of the fluid from a blister on your skin may be examined for bacteria that can cause gangrene.
• Imaging tests-
X-rays, CT-scans and MRI scans can show your organs, blood vessels and bones.
• Surgery –
Surgery may be done to get a better look inside the body and learn how much tissue is infected.
Treatment –
Tissue that has been damaged by gangrene can’t be saved, but steps can be taken to prevent gangrene from getting worse.The faster you get treatment, the better your chance for recovery.
Treatment for gangrene involve following ways or combination of these depending on the severity of your condition-
• Medications-
Medications to treat a bacterial infection (antibiotics) are given through an IV or taken by mouth.
Pain medications may be given to relieve discomfort.
• Surgery or other procedures –
Depending on the type of gangrene you have and its severity, you may need more then one surgery.Surgery for gangrene includes-
▪︎Debridement –
This type of surgery is done to remove the infected tissue and stop the infection from spreading. Your doctor may perform surgery to repair any damaged or diseased blood vessels to restore blood flow to the infected area.
▪︎Amputation –
In severe cases of gangrene, the infected body part- such as a toe, finger, arm or leg – may need to be surgically removed.
▪︎ Skin grafting (reconstructive surgery) –
Sometimes, surgery is needed to repair damaged skin o or to improve the appearance of the gangrene-related scars. Such surgery may be done using a skin graft.The healthy skin may be held in place by a dressing or by a couple of small stitches. A skin graft can be done only if there is enough blood supply to the area.
• Hyperbaric oxygen therapy –
It is done inside a chamber pressurized with pure oxygen.When you are safely exposed to increased pressure and oxygen, your blood can carry more oxygen. Oxygen rich blood slows the growth of bacteria that live in tissue lacking oxygen and helps infected wounds heal more easily.
Ayurvedic Perspective-
In Ayurveda, gangrene can be considered as Kotha under Dushta Vrana due to Margavarana (obstruction) Dhatu Kshaya. Margavarana is caused by imbalanced Tridosha, specially Pitta and Kapha.
Panchakarma Procedure –
• Jalokavacharan – .

Beneficial Herbs –
•Jati –

• Nirgundi –

•Neem –

•Haridra-

Effective Medications –
• Saptavinshti Gugglu
• Aarogyavardhini Vati
• Kaishore Gugglu
• Jatyadi Tail
• Sfatika Bhasm
• Ras Manikya

• Navkarshik Churna
• Gandhak Rasayan
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