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This article was co-written by Laura Marusinec, MD. Marusinec is a licensed pediatrician at Children’s Hospital of Wisconsin, and she is a member of the Clinical Practice Council. She received her PhD from the University of Wisconsin School of Medicine in 1995 and completed her residency at the University of Wisconsin School of Medicine with a major in Pediatrics in 1998. She is a member of the American Medical Writers Association and the American Medical Writers Association. Children’s Emergency Care Association.
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Dry gangrene is a fairly rare disease in which certain parts of the body gradually dry out and turn black due to lack of blood circulation. In severe cases, the skin and tissues even peel off. Dry gangrene differs from other forms of gangrene in that it is not accompanied by infection from burns or other trauma that cuts off blood supply to a part of the body and also does not drain pus or fluid. Dry gangrene usually affects the extremities, especially the hands and feet, but can also affect other organs such as limbs, muscles and even internal organs. People with underlying medical conditions such as diabetes, peripheral artery disease, or autoimmune diseases have a higher risk of developing dry gangrene. [1] X Research Source
Steps
Lifestyle change
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Stop smoking . Kicking this habit can help you prevent gangrene and disease progression, because smoking interferes with blood flow. When the blood stops circulating, the tissues die and cause gangrene. Anything that cuts off blood flow should be avoided, and that includes smoking, of course. [2] X Trusted Source National Health Service (UK) Go to Source
- The active substance nicotine in cigarettes is the culprit that has a strong impact on blood circulation. It constricts blood vessels, leading to poor blood flow. When blood flow to a certain part is poor, the amount of oxygen supplied will also be less. Chronic lack of oxygen in tissues causes them to necrosis (tissue death) and can lead to gangrene.
- Smoking is also linked to vascular disorders, a cause of narrowing and hardening of blood vessels.
- It is advisable to quit smoking gradually rather than abruptly, because sudden cessation of smoking can lead to severe withdrawal symptoms, making it difficult to maintain your determination to quit.
- Ask your doctor for help in quitting smoking.
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Adjust your diet. In gangrene, tissues and muscles are damaged due to poor blood circulation. Patients are therefore encouraged to eat foods that are high in protein and high in calories to aid in the healing of tissues and muscles. Protein can also help rebuild damaged muscles, and nutritious foods (instead of empty calories like fast food) provide the energy to help the body carry out its functions. [3] X Research Sources
- Foods that are high in protein but low in fat, thus helping to prevent clogged arteries, include turkey, fish, cheese, lean pork, lean beef, tofu, beans, and eggs and peanuts. Avoid high-fat foods such as red meat, butter, lard, hard cheeses, cakes, cookies, and fried foods. Instead, you should incorporate more green vegetables into the menu. [4] X Trusted Source National Health Service (UK) Go to Source
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Include foods rich in germanium and other antioxidants in your diet. Germanium is an antioxidant, and although the evidence is still oral, it is thought to help increase oxygen activity in the body. It also boosts the immune system and has anti-cancer properties. [5] X Research Sources
- Foods high in germanium include: garlic, onions, shiitake, whole-wheat flour, bran, ginseng, greens, and aloe. [6] X Research Sources[7] X Research Sources
- Due to the lack of solid scientific evidence regarding the effect of germanium on oxygen delivery to tissues in the case of gangrene, there are currently no dosing recommendations for germanium. You can check with your doctor to see if taking a germanium supplement is helpful for your particular situation.
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Be wary of sugar intake. While monitoring sugar intake is necessary for everyone, it is especially important in cases of diabetes. People with diabetes need to limit their sugar intake to keep their blood sugar at recommended levels, based on meal times, exercise schedules, and time of day. Diabetics should also regularly check the extremities for any signs of cuts, swelling, redness, or infection. [8] X Research Sources[9] X Trusted Source National Health Service (UK) Go to Source
- People with diabetic neuropathy should check their bodies daily for any symptoms such as numbness in the arms, legs, fingers and toes, as these are signs of poor circulation. High sugar levels are also associated with high blood pressure and adversely affect normal blood flow in the blood vessels.
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Limit alcohol intake. Drinking too much alcohol compared to the recommended daily limit can cause blood pressure to skyrocket, and the amount of cholesterol in the blood will also increase, causing blood vessel blockage. [10] X Trusted Source National Health Service (UK) Go to Source
- Alcohol intake per day is limited to 1 drink for women and 2 drinks for men. Note, 1 glass counts as one beer (350 ml), one glass of wine (150 ml) or a blend containing 45 ml of spirits. [11] X Research Source
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Do exercise. Although the effect of exercise on the progression and treatment of gangrene is not exactly known, exercise may help relieve some of the underlying diseases that cause gangrene. One study found that a 30 to 40-minute treadmill exercise program, three to four days a week, can help improve symptoms of limping, or painful leg cramps caused by the muscles in the legs. not getting enough blood. [12] X Research Source Jeffrey Berger MD, MS FAHA, William R Hiat MD. FAHA, Peripheral Arterial Disease: Medical Therapy in PAD Circulation 2012 126 491-500.
- Consider creating a workout regimen at home with moderate-intensity exercises, either on a treadmill or walking around the block as outlined above. Keep a walking journal to record your workout and any symptoms or sensations you may be experiencing. Consult your doctor before entering any exercise regimen if you have heart disease or pre-existing conditions.
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Do leg exercises. If you can’t move easily, you can do exercises that help increase passive range of motion. These exercises require someone to assist you to move your joints to the maximum extent within your range of motion to prevent contractures (permanent contractions of muscles and joints) and improve blood supply to special parts of the body. These exercises include:
- Head exercises such as turning the head, tilting or bending the head, touching the chin to the chest.
- Shoulder and elbow exercises such as elbow bends, up and down or back and forth movements.
- Exercises for the forearm and wrist such as wrist flexion, hand rotation, and up-and-down movements.
- Hand and finger exercises such as finger flexion, finger extension, and finger rotation.
- Hip and knee exercises such as hip and knee flexion, back and forth leg movement, and leg rotation.
- Foot exercises such as flexion, rotation and ankle movement, toe flexion and toe extension.
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Take care of all wounds. Wounds and burns need to be treated immediately as they can progress to non-healing wounds, especially for diabetics. Whether you already have gangrene or are worried that disease may develop, the most important thing is to keep the wound clean and protected as the body works to build a network of capillaries beneath the scab. Please follow these steps: [13] X Research Source
- Wash the wound with a solution of betadine or hydrogen peroxide and apply an antibiotic prescribed by your doctor.
- After thoroughly rinsing, cover the wound with a sterile gauze dressing and clean cotton socks. Cotton fabrics can draw moisture out of the wound and also help better air circulation, thereby aiding the healing process.
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Apply cayenne pepper, garlic, honey, or onions to the affected area. Cayenne pepper tincture, a liquid extract from cayenne pepper, can help relieve pain, improve circulatory system function, and reduce the risk of infection. Caynnene tinctures are available at drugstores. Apply to affected area two or three times daily or as advised by a physician. [14] X Research Source
- You can also crush a few cloves of garlic and apply it directly to the wound. It was the standard treatment during the first and second world wars, thanks to garlic’s antimicrobial properties that help prevent or treat infection for gangrene and its antiplatelet properties that help dissolve blood clots. gangrene. [15] X Research Resources Singh, Papu, Singh Javier, Singh Sweta et al, Greener Journal of Agricultural Sciences, Vpume 4 (6) pp 265-280) July 2014.
- Alternatively, you can bandage the wound with sliced onions. Cut an onion into slices and cover the affected area with a clean cloth. Leave it on for about 5-10 minutes, do it several times a day. This can improve circulation to the affected area. [16] X Research Source
- Try applying honey to the wound. Honey has long been used to treat burns, wounds and boils. [17] X Trusted Source DermNet NZ Go to source Research is still ongoing, but honey has been shown to have antibacterial properties. However you need to make sure to use sterile and tested honey. [18] X Trusted Source DermNet NZ Go to the source Apply honey to a cloth or gauze and apply it directly to the wound or you can buy pre-soaked gauze. [19] X Trusted Source DermNet NZ Go to Source
Medical treatment
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Surgical removal of dead tissue. Surgery is indicated when gangrene is severe and requires removal of dead tissue. Usually the amount of dead tissue that needs to be removed depends on the amount of blood reaching the damaged area and the location of the wound. This is the standard treatment for dry gangrene. These surgeries include: [20] X Research Sources[21] X Trusted Source Mayo Clinic Go to Source
- Necrotizing skin debridement — This surgery removes dead tissue from gangrene. Sometimes the necrotic layer of skin can be replaced with new healthy skin tissue (also called a skin graft). [22] X Research Source
- Amputation — If all of the tissue is dead and medications or other surgery don’t save it, limbs or other parts may have to be amputated to prevent gangrene from spreading to surrounding and other parts of the body . This surgery is indicated when surgical removal of necrotic skin is not effective. Note that, unless it is life-threatening, the decision to have surgery is only made after you have been thoroughly consulted by your doctor and have all the information needed to make the right choice. [23] X Trusted Source National Health Service (UK) Go to Source
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Consider maggot therapy. As an alternative to surgery, maggot therapy works similarly to remove dead tissue. With this nonsurgical therapy, the fly larvae are placed in the gangrene area and covered with gauze. The maggots will eat the dead tissue and luckily they don’t touch the healthy tissue. Maggot therapy also works against infections because they secrete substances that kill bacteria. [24] X Trusted Source National Health Service (UK) Go to Source
- Some studies suggest that maggot therapy may be more effective than surgical removal of necrotic skin. However, many people are too scared or hesitant to try this therapy because they can’t stand the “horror”. [25] X Trusted Source National Health Service (UK) Go to Source
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Use hyperbaric oxygen therapy. This is an alternative therapy in which the patient is placed in a special chamber filled with compressed air. You will then be covered with a hood to breathe pure oxygen. It may sound a bit scary, but this therapy is an effective way to increase blood oxygen levels, deliver oxygen to the damaged areas, and improve circulation and blood flow. Blood will reach the gangrene even in patients with poor blood flow. [26] X Research Source
- Once the damaged areas are supplied with enough oxygen, the risk of having to have organs removed is reduced. Research has validated the effectiveness of hyperbaric oxygen therapy in the treatment of diabetic foot gangrene, thereby reducing the risk of amputation.
- You should consult your doctor to see if hyperbaric oxygen therapy is right for you. [27] X Trusted Source National Health Service (UK) Go to Source
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Surgical restoration of blood circulation. The main types of surgery to restore blood circulation are bypass surgery and angioplasty. Studies have shown that the two types of surgery are equally effective in restoring blood circulation and reducing the risk of having to have organs removed. However, angioplasty has a faster recovery time, and bypass surgery may be more effective in the long run. Consult with your doctor to find out what type of surgery is best for your particular medical history and condition. [28] X Trusted Source National Health Service (UK) Go to Source
- Bypass surgery – With this surgery, the surgeon redirects blood flow by “bridging” the blockage. Grafting is used to connect a vein to a healthy part of one of the arteries.
- Angioplasty – During an angioplasty, a tiny balloon is placed into a blocked or very narrow artery. This small balloon then inflates and helps widen the blood vessel. In some cases, the surgeon may also insert a metal tube, called a stent, into the artery to dilate the artery.
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Use clot-reducing medication. Your doctor may also prescribe anticoagulants to reduce the formation of blood clots, thereby improving blood flow. Warfarin is an anticoagulant medicine, usually taken by mouth as a tablet (2 to 5 mg) once a day (at the same time). Warfarin inhibits and is resistant to vitamin K, thereby slowing blood clotting. As a result, the blood will thin and circulate better.
- Remember that anticoagulants will make it easier for you to bleed. You may not be able to take anticoagulants if you have a history of blood problems (such as a clotting disorder), cancer, kidney or liver disease, heart disease or high blood pressure, and some others. Always consult your doctor before taking any medication that affects blood flow and blood clotting.
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Treatment of infections. Antibiotics are often prescribed for patients with gangrene due to infection or for patients at risk of infection due to open wounds or wounds that are difficult to heal. Usually, doctors will prescribe antibiotics for patients with gangrene after surgery to remove tissue to fight infection for the remaining tissue. Commonly prescribed medications include: [29] X Research Sources[30] X Research Sources
- Penicillin G — This is an antibiotic that has long been used to treat gangrene. The usual dose is 10-24 million units (every six or eight hours) administered intravenously or intramuscularly. Penicillin G is bacteriostatic, that is, inhibiting or stopping bacteria from multiplying and growing. Usually, in severe infections or in patients undergoing surgery, injection is indicated because the parenteral route can use a higher dose and reach the affected area faster than the oral route. Doctors now often prescribe a combination of penicillin and clindamycin, a protein inhibitor. [31] X Trusted Source National Health Service (UK) Go to Source
- Clindamycin — This medication is used to treat and prevent infections by killing bacteria by blocking the production of proteins in the bacteria. Bacteria cannot survive without these proteins. The usual dose is 300-600 mg, every six to eight hours by mouth, or 1.2 grams intravenously, twice daily. [32] X Research Source
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Begin the care process. Usually you will be cared for by a patient care program after surgery. This is a necessary therapy to restore normal function of the legs, hands, toes or fingers. Part of rehabilitation therapy includes isotonic exercises to maintain function of the affected area. [33] X Source of Research These exercises help engage the joints with the muscles in the arms and legs. Isometric exercises include:
- Walk fast or slow
- Cycling
- Dance
- Rope skipping
Understanding the disease
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Know the cause of gangrene. Gangrene can be caused by the following factors: [34] X Trusted Source Mayo Clinic Go to Source
- Diabetes — This disease interferes with blood circulation, especially in the lower extremities, and can lead to irreversible wounds. [35] X Research Source
- Vascular diseases — Vascular diseases, such as peripheral artery disease (PAD), can reduce blood flow in the body. For example, PAD occurs when the arteries narrow, mainly due to atherosclerosis, which hardens the arteries and blood vessels. [36] X Research Source
- Vasculitis — Vasculitis refers to certain autoimmune diseases that cause blood vessels to become inflamed, such as Raynaud’s phenomenon. With these autoimmune diseases, the blood vessels leading to the fingers and feet become temporarily constricted (vasospasm), causing vasospasm, or narrowing of the blood vessels. Causes of Raynaud’s phenomenon include exposure to cold temperatures and stress. [37] X Research Source HD Spomon MD Raynaud’s phenomenon, Cardiovascular Journal of Africa, 2011 Oct (5) 233.
- Tobacco addiction — Tobacco can clog arteries and thereby impair blood flow.
- External wounds — Burns, accidents, wounds or incisions can damage certain cells in the body, resulting in a slower rate of blood flow. If the wound is not treated properly and the main blood vessel is damaged or weakened, it will no longer be able to carry enough blood to the surrounding tissues. This leads to a lack of oxygen supply to the body parts and death of the surrounding tissues.
- Frostbite — Exposure to extreme cold can prevent normal blood circulation. Frostbite can happen in freezing weather in as little as 15 minutes. Frostbite usually affects the fingers and toes. To prevent frostbite, you can wear properly lined gloves and shoes to keep warm and resist moisture.
- Infection — An untreated bacterial infection can spread through damaged tissue, causing tissue death and leading to gangrene.
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Understand the types of gangrene. Gangrene can be classified into different types, including: [38] X Research Source[39] X Research Source
- Dry gangrene — this form of gangrene is characterized by dry and necrotic skin with brown to purple-blue to black coloration. The condition usually progresses slowly and eventually the tissue is shed. Dry gangrene can become wet gangrene if infected.
- Wet gangrene — The common feature of wet gangrene is the swelling, blistering, and wetness of the damaged tissue due to exudate. Wet gangrene develops after damaged tissues become infected. This form of gangrene requires urgent treatment because of its rapid growth rate and can be very dangerous.
- Vapor gangrene — This form of gangrene is a subtype of wet gangrene. In this form of gangrene, the skin surface of the lesion appears normal at first, but will become pale and turn gray to crimson as the disease progresses. The blisters on the skin will be more visible and when pressed, there will be a crackling sound. This condition is caused by infection with clostridium perfringens , a gas-producing bacteria that causes tissue death by vapor.
- Facial gangrene — This is a rapidly progressive form of gangrene that mainly occurs in the mouth and face. This form of the disease often occurs in children who are malnourished and live in unsanitary conditions.
- Organ gangrene — This form of gangrene occurs when blood flow to internal organs such as the intestines, gallbladder, or appendix is blocked. This disease often causes fever and severe pain, and can be fatal if left untreated.
- Fournier’s gangrene — This form of gangrene is very rare and involves the genitals and urinary tract. The disease occurs more often in men than in women.
- Meleney’s gangrene — This is an uncommon form of gangrene that occurs after surgery, with damaged and painful skin, appearing within one to two weeks after surgery. The wound is painful and itchy.
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Know the symptoms of dry gangrene. Dry gangrene is a serious disease that requires urgent treatment. Anyone with the following symptoms should see a doctor immediately to avoid complications: [40] X Research Source
- The affected area is numb and cold, and the skin is atrophied
- Limping or cramping (such as a condition in the leg when walking)
- Feeling of “pins and needles”, numbness or tingling
- Discolored area (may be red, pale, purple and gradually black if left untreated)
- The damaged area is dry
- Painful
- Septic shock (low blood pressure, possible fever, confusion, dizziness, shortness of breath). Septic shock is considered an emergency and requires immediate medical attention. This condition is rare in gangrene, but it can happen if not treated properly.
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Find a medical emergency. This is not a disease that can be delayed. You may have to have a limb or other body parts amputated if not treated quickly. You need to quickly go to the doctor for treatment as soon as possible.
- Note that some people do not feel pain with dry gangrene, so they do not seek medical attention until the extremities have turned black. Be careful and tell your doctor as soon as you notice any of the symptoms listed above. Don’t wait until the situation becomes serious.
- While home remedies are also very good, they are often not effective enough in curing dry gangrene. You need early treatment for the symptoms to go away faster.
Warning
- You should consult your doctor as soon as you notice any symptoms to ensure prompt diagnosis and treatment.
- If you are at risk of developing dry gangrene, especially if you have diabetes or peripheral artery disease, you should learn about dry gangrene and carefully monitor any symptoms. [41] X Source of Study Regularly visit your doctor for information about risks and symptoms.
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This article was co-written by Laura Marusinec, MD. Marusinec is a licensed pediatrician at Children’s Hospital of Wisconsin, and she is a member of the Clinical Practice Council. She received her PhD from the University of Wisconsin School of Medicine in 1995 and completed her residency at the University of Wisconsin School of Medicine with a major in Pediatrics in 1998. She is a member of the American Medical Writers Association and the American Medical Writers Association. Children’s Emergency Care Association.
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Dry gangrene is a fairly rare disease in which certain parts of the body gradually dry out and turn black due to lack of blood circulation. In severe cases, the skin and tissues even peel off. Dry gangrene differs from other forms of gangrene in that it is not accompanied by infection from burns or other trauma that cuts off blood supply to a part of the body and also does not drain pus or fluid. Dry gangrene usually affects the extremities, especially the hands and feet, but can also affect other organs such as limbs, muscles and even internal organs. People with underlying medical conditions such as diabetes, peripheral artery disease, or autoimmune diseases have a higher risk of developing dry gangrene. [1] X Research Source
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