Gangrene
Gangrene is a serious condition where a loss of Blood supply causes body tissue to die. It can affect any part of the body but typically starts in the toes, feet, fingers and hands.
Gangrene can occur as a result of an injury, infection or a long-term condition that affects blood circulation.
Symptoms of gangrene include:
redness and swelling in the affected area
either a loss of sensation or severe pain in the affected area
sores or blisters in the affected area that bleed or produce a foul-smelling pus
You should see your GP immediately if you're worried you may have gangrene.
Who's affected
Anyone can develop gangrene, particularly after a serious injury, but there are certain groups of people who are more at risk.
These include people with long-term conditions that can affect the blood vessels, such as:
diabetes – a lifelong condition that causes a person's blood sugar level to become too high
atherosclerosis – where the arteries become clogged up with a fatty substance called plaque, narrowing them and restricting blood flow
peripheral arterial disease – where a build-up of fatty deposits in the arteries restricts blood supply to leg muscles
Raynaud's – where blood vessels in certain parts of the body, usually the fingers or toes, react abnormally to cold temperatures
How gangrene is treated
The earlier treatment for gangrene begins, the more successful it's likely to be. The main treatments include surgery to remove damaged tissue, known as debridement, and antibiotics to treat any underlying infection.
In some cases, surgery may be needed to restore blood flow to the affected area.
In more severe cases, it may be necessary to remove an entire body part such as a toe, foot, or lower leg. This is known as amputation.
Preventing gangrene
Many cases of gangrene can be prevented.
If you have a condition that increases your risk of getting gangrene, such as diabetes, it's important you have regular check-ups to assess the state of your feet. Report any problems to your GP as soon as possible.
Stopping smoking if you smoke and adopting a healthy lifestyle, with a low-fat diet and regular exercise, can also improve your circulation and reduce your risk of developing gangrene.
Symptoms - Gangrene
The symptoms of gangrene vary depending on the underlying cause. It can affect any part of the body, but typically starts in the toes, feet, fingers or hands.
General symptoms of gangrene include:
initial redness and swelling
either a loss of sensation or severe pain in the affected area
sores or blisters that bleed or release a dirty-looking or foul-smelling discharge (if the gangrene is caused by an infection)
the skin becoming cold and pale
In some cases, the affected limb may feel heavy and pressing the skin may produce a crackling sound. These symptoms are caused by a build-up of gas under the skin.
If the area is infected, you may also have other signs related to the underlying infection, such as:
a high temperature of 38C or above
feeling hot and shivery
loss of appetite
rapid heartbeat and breathing
dizziness
Without treatment the affected tissue will start to die. When this happens, the area changes colour from red to brown to purple or black, before shrivelling up and falling away from the surrounding healthy tissue.
When to seek medical advice
The earlier treatment for gangrene begins, the more effective it's likely to be. Contact your GP immediately if you have:
any of the symptoms of gangrene mentioned above
a persistent fever
a wound that's unusually slow to heal
If your GP isn't available, call NHS 111 or your local out-of-hours service for advice.
When to seek emergency help
If bacteria from gangrene pass into your bloodstream, you could go into septic shock. This is a life-threatening condition that occurs when an infection causes your blood pressure to drop to a dangerously low level.
Signs of septic shock include:
a rapid but weak pulse
dizziness when you stand up
a change in your mental state, such as confusion or disorientation
breathing difficulties
vomiting
diarrhoea
cold, clammy and pale skin
Dial 999 immediately to request an ambulance if you suspect that you or someone you know is in septic shock.
Causes - Gangrene
Gangrene can develop when the supply of blood to an area of your body is interrupted.
This can occur as the result of an injury, an infection, or an underlying condition that affects your circulation.
Types of gangrene
There are several different types of gangrene, each with a different cause. The main types are:
dry gangrene – where the blood flow to an area of the body becomes blocked
wet gangrene – caused by a combination of an injury and bacterial infection
gas gangrene – where an infection develops deep inside the body and the bacteria responsible begin releasing gas
necrotising fasciitis – caused by a serious bacterial infection that spreads quickly through the deeper layers of skin and tissue
internal gangrene – where the blood flow to an internal organ, usually the intestines, gallbladder or appendix, becomes blocked
Who's most at risk?
People most at risk of gangrene are those with an underlying health condition that can affect the blood vessels and arteries (particularly if it's poorly managed), and those with a weakened immune system.
Conditions affecting the blood vessels
Conditions that can affect the blood vessels and increase your risk of developing gangrene include:
