Gangrene occurs when the skin changes color. It starts as red or purple, then bluish gray and eventually black. The affected area feels heavy and produces a crackling sound when pressed.
Health care providers diagnose gangrene by taking a look at the affected area and running tests. They may do blood tests and a bacteria culture test to find out the type of bacteria causing the infection.
Pain
If an injury to your limb or other body part doesn’t heal quickly, it might lead to gangrene. The affected area may look dry and shriveled, or it may have a bubbly or oozing appearance (wet gangrene). It might smell bad, because bacterial infection can cause the tissue to decay. In addition, the affected skin can feel cold and numb to the touch. The infection can also make you sick and feverish. The condition can spread to your bloodstream, which causes a life-threatening reaction called sepsis.
The first sign of gangrene is usually pain, although in some cases it develops slowly and doesn’t have any symptoms. Your health care provider can diagnose gangrene with a physical exam and tests, including blood work to see if you have an infection, and imaging tests like a CT scan or magnetic resonance imaging (MRI).
Dry gangrene happens when your blood supply to a large area of your body is cut off. It often affects your hands and feet, and it can occur from conditions like diabetes or vascular disease. The affected area becomes dry, shrinks, and turns a brown or purplish-blue or black color. It can eventually swell and start to leak fluid. If bacteria invade this dead and rotting tissue, it develops a foul-smelling discharge that’s sometimes described as smelling like a corpse or putrescine.
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Wet gangrene is more serious than dry gangrene and can be deadly. It starts with a swollen area of the skin, usually red at first, that oozes a foul-smelling fluid or has noticeable sores and blisters. In some cases, the disease can also infect your internal organs and cause them to shut down. The infection can cause a life-threatening reaction called sepsis, in which your blood pressure plunges and you’re at risk of heart attacks, strokes, or amputations.
Loss of Sensation
While there are several different types of gangrene, the common factor is death of tissues due to lack of blood flow. All forms of gangrene happen because of poor circulation, often caused by disease, injury, or surgery. The most common forms include dry and wet gangrene. Dry forms usually develop over days or months and progress to wet gangrene if left untreated. They occur because of chronic health problems such as diabetes, peripheral artery disease, and high blood pressure. Constriction of the limbs or feet from tight bands or shoes, or frostbite, can also reduce the supply of blood to those parts of your body.
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Wet gangrene develops much faster than the dry form and is often associated with infection. It is often painful and may have a foul odor because of bacteria such as Clostridia that produce gas. This gas causes the affected area to change color from red or purple, to bluish gray or black, and eventually shrivels up, sometimes with a crackling sound when touched. If not treated, the affected limb can die and cause sepsis (a life-threatening reaction to the infection).
A doctor will do a physical exam of the affected part of your body to check for signs of gangrene. They will also ask you about your past health, including any surgeries or injuries that might have damaged your circulation. If they suspect you have gangrene, they may send a sample of the affected tissue for culture. They will also likely recommend oxygen therapy to help with healing and lower your risk for infections that can cause septic shock. They might prescribe antibiotics to treat the underlying infection, and you will probably need surgery to remove the dead tissue.
Loss of Taste
If you have gangrene, you might not be able to taste anything, due to the loss of tissue in the affected area. You may also notice a foul smell, known as cadaverine or putrescine, from the decay of dead tissues and the bacterial infection. This odor might be more noticeable with wet gangrene, where the affected areas develop swelling and a spongy appearance and might ooze pus.
The diagnosis is made based on a physical exam and a patient’s history of illness, including chronic conditions such as diabetes and poor circulation. A healthcare provider might also ask whether the person has had recent injuries or surgery and if he or she uses cigarette smoking products. A sample of the skin and blood might be taken from the affected area to test for a bacterial infection, as well.
Gangrene usually affects the parts of your body farthest from your core, such as the fingers, toes and limbs. But it can also occur in your internal organs, such as the gallbladder or intestines. If left untreated, gangrene can lead to serious complications, including amputation and even death.
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The treatment depends on the type of gangrene and how far it has spread. If you have wet gangrene, your doctor will need to remove the dead tissue surgically and use antibiotics to kill any bacteria. This is usually done in a hospital. Other treatments include surgery to restore blood flow — such as bypass surgery or angioplasty — and hyperbaric oxygen therapy, in which you lie in a chamber that forces high levels of oxygen into the bloodstream to promote healing and ward off infections. Often, you will need to be in the hospital for up to 48 hours.
Bloody Wounds
The death of tissue in gangrene leaves open wounds that may bleed. The rotting process also causes a foul smell, as dead tissues break down and produce toxins. These toxins are carried by blood through the bloodstream to other parts of the body, where they can damage organs or kill them.
If wet gangrene progresses untreated, it can cause septic shock. This life-threatening condition happens when bacteria in the gangrene reach your bloodstream and cause your blood pressure to drop to dangerously low levels.
A healthcare professional can diagnose gangrene with a thorough physical exam and a detailed medical history. They will look for any chronic health conditions that increase your risk of gangrene, such as diabetes. They will also examine the affected area to check for signs of tissue death. In some cases, they will perform a needle aspiration or surgically remove a small sample of affected tissue for examination under a microscope to confirm the diagnosis.
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Treatment for gangrene depends on the type and extent of affected tissue. If wet gangrene is present, the healthcare professional will need to perform tissue debridement and remove any dead or dying tissues. This will likely require a hospital visit. The doctor will then start you on antibiotics to prevent any further infection and treat any underlying conditions that are contributing to the gangrene. They will also administer pain killers to reduce any initial pain.
If the gangrene is extensive, you might need to have an amputation to control spread and prevent severe infection and shock. Once the dead tissues are removed, you can begin recovery. This can be a difficult transition, but physical therapy can help you learn to live without the use of the affected limb or digit.
