Coping with GANGRENE

With this condition, a loss of blood supply causes body tissue to die

Gangrene can affect any part of the body but typically starts in the toes, feet, fingers and hands, occurring as a result of injury, infection or a long-term condition that affects blood circulation. Without treatment the affected tissue starts to die, swelling, and becoming red, brown, purple or black, before shrivelling up and falling off.

There’s loss of sensation or severe pain, sores or blisters that bleed or produce foul-smelling pus. Pressing the skin may produce a crackling sound due to a build-up of gas underneath. If infected, you may feel hot and shivery.

Gangrene may be dry, where the blood flow to a tissue becomes blocked; wet, caused by an injury and bacterial infection; or gas gangrene, where infection develops deep inside the body with the bacteria releasing gas. Necrotising fasciitis is a serious bacterial infection spreading quickly through the deeper tissue layers, while internal gangrene affects an internal organ, usually the intestines, gallbladder or appendix.

If you suspect you have gangrene, you must see a doctor immediately, who will arrange admission for blood tests, including for immune status, diabetes, kidney and liver function, and blood cultures to confirm specific acute infections. You may also have samples sent for fluid or tissue culture to find which bacteria are responsible. Imaging tests, such as ultrasound, X-ray, CT and MRI, can confirm the location and spread of tissue damage, and study blood vessels involved.

Surgical examination under anaesthetic may be needed to confirm the diagnosis of gangrene deeper inside the body.

Anyone can develop gangrene, especially after serious injury, but risks are higher if you have a long-term condition

that affects the blood vessels, such as diabetes, atherosclerosis, peripheral arterial disease or Raynaud’s.

It’s vital that treatment starts early, as gangrene can spread rapidly. This could include surgery to remove damaged tissue (debridement) and antibiotics for any underlying infection. Surgery may be needed to restore blood flow to the affected area. In severe cases, amputation of a digit or limb may be needed. If bacteria from the gangrene get into your blood, you may develop sepsis and need emergency treatment.

Your risk of gangrene can be reduced by improving circulation through good management of long-term conditions such as diabetes, good foot care and reporting problems early, stopping smoking if you smoke, and adopting a healthy lifestyle, with a low-fat diet and regular exercise.