Gangrene is a serious and potentially life-threatening condition that arises when a considerable mass of body tissue dies (necrosis Necrosis is the premature death of cells and living tissue. Necrosis is caused by factors external to the cell or tissue, such as infection, toxins, or trauma. This is in contrast to apoptosis, which is a naturally occurring cause of cellular death. While apoptosis often provides beneficial effects to the organism, necrosis is almost always).[1][2] This may occur after an injury or infection, or in people suffering from any chronic health problem affecting blood circulation The circulatory system is an organ system that passes nutrients , gases, hormones, blood cells, etc. to and from cells in the body to help fight diseases and help stabilize body temperature and pH to maintain homeostasis.[2] The prime cause of gangrene is reduced blood supply to the affected tissues, which results in cell The cell is the functional basic unit of life. It was discovered by Robert Hooke and is the functional unit of all known living organisms. It is the smallest unit of life that is classified as a living thing, and is often called the building block of life. Some organisms, such as most bacteria, are unicellular . Other organisms, such as humans, death.[3] Diabetes Diabetes mellitus, often simply referred to as diabetes—is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria , polydipsia (increased thirst) and long-term smoking increase the risk of suffering from gangrene.[2][3]
There are different types of gangrene with different symptoms, such as dry gangrene, wet gangrene, gas gangrene Gas gangrene is a bacterial infection that produces gas within tissues in gangrene. It is a deadly form of gangrene usually caused by Clostridium bacteria. It is a medical emergency, internal gangrene and necrotising fasciitis.[1][2] Treatment options include debridement Debridement is the medical removal of a patient's dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. Removal may be surgical, mechanical, chemical, autolytic , and by maggot therapy, where certain species of live maggots selectively eat only necrotic tissue (or, in severe cases, amputation Amputation is the removal of a body extremity by trauma or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventative surgery for such problems. A special case is the congenital amputation, a congenital) of the affected body parts, antibiotics In common usage, an antibiotic is a substance or compound that kills bacteria or inhibits their growth. Antibiotics belong to the broader group of antimicrobial compounds, used to treat infections caused by microorganisms, including fungi and protozoa, vascular surgery Vascular surgery is a specialty of surgery in which diseases of the vascular system, or arteries and veins, are managed by medical therapy, minimally-invasive catheter procedures, and surgical reconstruction. The specialty evolved from general and cardiac surgery. Early pioneers of the field include Russian surgeon Nikolai Korotkov, noted for, maggot therapy Maggot therapy (also known as maggot debridement therapy , larval therapy, larva therapy, larvae therapy, biodebridement or biosurgery) is a type of biotherapy involving the intentional introduction of live, disinfected maggots (fly larvae) into the non-healing skin and soft tissue wound(s) of a human or animal for the purposes of selectively or hyperbaric oxygen therapy Hyperbaric medicine, also known as hyperbaric oxygen therapy , is the medical use of oxygen at a level higher than atmospheric pressure.[4]
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Etymology
The etymology Etymology is the study of the history of words, their origins, and how their form and meaning have changed over time of gangrene derives from the Latin Latin or sometimes Roman is an Italic language originally spoken in Latium and Ancient Rome. Although often considered a dead language, in view of the fact that it has no native speakers, a small number of scholars can fluently speak it and it continues to be taught in schools and universities and has been, and currently is, used in the process of word "gangraena" and from the Greek Greek , an independent branch of the Indo-European family of languages, is the language of the Greeks. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. In its ancient form, it is the language of classical ancient Greek literature and the New Testament of gangraina (γάγγραινα), which means "putrefaction Putrefaction is the decomposition of animal proteins, especially by anaerobic microorganisms, described as putrefying bacteria. Decomposition is a more general process. Putrefaction usually results in amines such as putrescine and cadaverine, which have a putrid odor. Material that is subject to putrefaction is called putrescible of tissues". It has no etymological connection with the word green Green is a color, the perception of which is evoked by light having a spectrum dominated by energy with a wavelength of roughly 520–570 nanometres. In the subtractive color system, it is not a primary color, but is created out of a mixture of yellow and blue, or yellow and cyan; it is considered one of the additive primary colors. On the HSV, despite the affected areas turning black and/or green and/or yellowish brown. It is coincidence that, in Lowland Scots the words "gang green" (going green) can be said to be an eggcorn In linguistics, an eggcorn is an idiosyncratic substitution of a word or phrase for a word or words that sound similar or identical in the speaker's dialect. The new phrase introduces a meaning that is different from the original, but plausible in the same context, such as "old-timers' disease" for "Alzheimer's disease". This for gangrene, as it describes the symptoms of the affliction.
Causes
Gangrene is caused by infection An infection is the detrimental colonization of a host organism by a foreign species. In an infection, the infecting organism seeks to utilize the host's resources to multiply, usually at the expense of the host. The infecting organism, or pathogen, interferes with the normal functioning of the host and can lead to chronic wounds, gangrene, loss or ischemia In medicine, ischemia is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. It may also be spelled ischaemia or ischæmia. It also means local anemia in a given part of a body sometimes resulting from vasoconstriction, thrombosis or embolism, such as by the bacteria Clostridium perfringens Clostridium perfringens is a Gram-positive, rod-shaped, anaerobic, spore-forming bacterium of the genus Clostridium. C. perfringens is ubiquitous in nature and can be found as a normal component of decaying vegetation, marine sediment, the intestinal tract of humans and other vertebrates, insects, and soil[5] or by thrombosis Thrombosis is the formation of a blood clot (thrombus; Greek: θρόμβος) inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel is injured, the body uses platelets and fibrin to form a blood clot to prevent blood loss. Alternatively, even when a blood vessel is not injured, blood clots may (blocked blood vessel The blood vessels are the part of the circulatory system that transport blood throughout the body. There are three major types of blood vessels: the arteries, which carry the blood away from the heart; the capillaries, which enable the actual exchange of water and chemicals between the blood and the tissues; and the veins, which carry blood from). It is usually the result of critically insufficient blood Blood is a specialized bodily fluid that delivers necessary substances to the body's cells – such as nutrients and oxygen – and transports waste products away from those same cells supply (e.g., peripheral vascular disease Peripheral vascular disease , also known as peripheral artery disease (PAD) or peripheral artery occlusive disease (PAOD), includes all diseases caused by the obstruction of large arteries in the arms and legs. PVD can result from atherosclerosis, inflammatory processes leading to stenosis, an embolism, or thrombus formation. It causes either) and is often associated with diabetes Diabetes mellitus, often simply referred to as diabetes—is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria , polydipsia (increased thirst) and long-term smoking. This condition is most common in the lower extremities. The best treatment for gangrene is revascularization Revascularization is "a surgical procedure for the provision of a new, additional, or augmented blood supply to a body part or organ." The term derives from the prefix re-, in this case meaning "restoration" and vasculature, which refers to the circulatory structures of an organ.[citation needed] (i.e., restoration of blood flow) of the affected organ, which can reverse some of the effects of necrosis and allow healing. Other treatments include debridement Debridement is the medical removal of a patient's dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. Removal may be surgical, mechanical, chemical, autolytic , and by maggot therapy, where certain species of live maggots selectively eat only necrotic tissue and surgical amputation Amputation is the removal of a body extremity by trauma or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventative surgery for such problems. A special case is the congenital amputation, a congenital. The method of treatment is, in general, determined depending on location of affected tissue and extent of tissue loss. Gangrene may appear as one effect of foot binding Foot binding was a custom practiced on young girls and women for approximately one thousand years in China, beginning in the 10th century and ending in the first half of 20th century.
Types of gangrene
Dry gangrene
Dry gangrene begins at the distal part of the limb due to ischemia In medicine, ischemia is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. It may also be spelled ischaemia or ischæmia. It also means local anemia in a given part of a body sometimes resulting from vasoconstriction, thrombosis or embolism and often occurs in the toes and feet of elderly patients due to arteriosclerosis It should not be confused with "arteriolosclerosis" or "atherosclerosis", which are described in greater detail below. Dry gangrene spreads slowly until it reaches the point where the blood supply is inadequate to keep tissue viable. The affected part is dry, shrunken and dark black, resembling mummified A mummy is a corpse whose skin and organs have been preserved by either intentional or incidental exposure to chemicals, extreme coldness, very low humidity, or lack of air when bodies are submerged in bogs. Presently, the oldest discovered mummified human corpse was a decapitated head dated as 6,000 years old and was found in 1936. The most flesh. The dark coloration is due to liberation of hemoglobin Hemoglobin is the iron-containing oxygen-transport metalloprotein in the red blood cells of vertebrates and the tissues of some invertebrates. Hemoglobin in the blood is what transports oxygen from the lungs or gills to the rest of the body (i.e. the tissues) where it releases the oxygen for cell use from hemolyzed red blood cells, which is acted upon by hydrogen sulfide Hydrogen sulfide is the chemical compound with the formula H2S. It is a colorless, very poisonous, flammable gas with the characteristic foul odor of rotten eggs. It often results from the bacterial breakdown of organic matter in the absence of oxygen, such as in swamps and sewers (anaerobic digestion). It also occurs in volcanic gases, natural (H2S) produced by the bacteria, resulting in formation of black iron sulfide that remains in the tissues.[6] The line of separation usually brings about complete separation with eventual falling off of the gangrenous tissue if it is not removed surgically.
If the blood flow is interrupted for a reason other than severe bacterial infection, the result is a case of dry gangrene. People with impaired peripheral blood flow, such as diabetics, are at greater risk of developing dry gangrene.
The early signs of dry gangrene are a dull ache and sensation of coldness in the affected area along with pallor Pallor is a reduced amount of oxyhemoglobin in skin or mucous membrane, a pale color which can be caused by illness, emotional shock or stress, stimulant use, lack of exposure to sunlight, anemia or genetics. It is more evident on the face and palms. It can develop suddenly or gradually, depending on the cause of the flesh. If caught early, the process can sometimes be reversed by vascular surgery. However, if necrosis sets in, the affected tissue must be removed just as with wet gangrene.
Wet gangrene
Wet gangrene occurs in naturally moist tissue and organs such as the mouth, bowel, lungs, cervix, and vulva.[citation needed] Bedsores occurring on body parts such as the sacrum, buttocks, and heels — although not necessarily moist areas — are also categorized as wet gangrene infections. In wet gangrene, the tissue is infected by saprogenic microorganisms (Bac. perfringens, fusiformis, putrificans, etc.), which cause tissue to swell and emit a fetid smell. Wet gangrene usually develops rapidly due to blockage of venous and/or arterial blood flow. The affected part is saturated with stagnant blood, which promotes the rapid growth of bacteria. The toxic products formed by bacteria are absorbed causing systemic manifestation of septicemia Sepsis is a serious medical condition that is characterized by a whole-body inflammatory state and the presence of a known or suspected infection. The body may develop this inflammatory response by the immune system to microbes in the blood, urine, lungs, skin, or other tissues. A lay term for sepsis is blood poisoning, more aptly applied to and finally death. The affected part is edematous, soft, putrid, rotten and dark. The darkness in wet gangrene occurs due to the same mechanism as in dry gangrene.
Gas gangrene
Main article: Gas gangrene Gas gangrene is a bacterial infection that produces gas within tissues in gangrene. It is a deadly form of gangrene usually caused by Clostridium bacteria. It is a medical emergencyGas gangrene is a bacterial infection that produces gas within tissues. It is a deadly form of gangrene usually caused by Clostridium perfringens Clostridium perfringens is a Gram-positive, rod-shaped, anaerobic, spore-forming bacterium of the genus Clostridium. C. perfringens is ubiquitous in nature and can be found as a normal component of decaying vegetation, marine sediment, the intestinal tract of humans and other vertebrates, insects, and soil bacteria. Infection spreads rapidly as the gases produced by bacteria expand and infiltrate healthy tissue in the vicinity. Because of its ability to quickly spread to surrounding tissues, gas gangrene should be treated as a medical emergency A medical emergency is an injury or illness that is acute and poses an immediate risk to a person's life or long term health. These emergencies may require assistance from another person, who should ideally be suitably qualified to do so, although some of these emergencies can be dealt with by the victim themselves. Dependent on the severity of.
Gas gangrene is caused by a bacterial exotoxin An exotoxin is a toxin excreted by a microorganism, including bacteria, fungi, algae, and protozoa.[clarification needed] An exotoxin can cause damage to the host by destroying cells or disrupting normal cellular metabolism. They are highly potent and can cause major damage to the host. Exotoxins may be secreted, or, similar to endotoxins, may be-producing clostridial species, which are mostly found in soil and other anaerobes (e.g., Bacteroides Bacteroides is a genus of Gram-negative, bacillus bacteria. Bacteroides species are non-endospore-forming, anaerobes, and may be either motile or non-motile, depending on the species. The DNA base composition is 40-48% GC. Unusual in bacterial organisms, Bacteroides membranes contain sphingolipids. They also contain meso-diaminopimelic acid in and anaerobic streptococci Streptococcus is a genus of spherical Gram-positive bacteria belonging to the phylum Firmicutes and the lactic acid bacteria group. Cellular division occurs along a single axis in these bacteria, and thus they grow in chains or pairs, hence the name — from Greek στρεπτος streptos, meaning easily bent or twisted, like a chain . Contrast). These environmental bacteria may enter the muscle through a wound and subsequently proliferate in necrotic tissue and secrete powerful toxins. These toxins destroy nearby tissue, generating gas at the same time. A gas composition of 5.9% hydrogen, 3.4% carbon dioxide, 74.5% nitrogen, and 16.1% oxygen was reported in one clinical case.[7]
Gas gangrene can cause necrosis Necrosis is the premature death of cells and living tissue. Necrosis is caused by factors external to the cell or tissue, such as infection, toxins, or trauma. This is in contrast to apoptosis, which is a naturally occurring cause of cellular death. While apoptosis often provides beneficial effects to the organism, necrosis is almost always, gas production, and sepsis Sepsis is a serious medical condition that is characterized by a whole-body inflammatory state and the presence of a known or suspected infection. The body may develop this inflammatory response by the immune system to microbes in the blood, urine, lungs, skin, or other tissues. A lay term for sepsis is blood poisoning, more aptly applied to. Progression to toxemia Bacteremia is the presence of bacteria in the blood. The blood is normally a sterile environment, so the detection of bacteria in the blood (most commonly with blood cultures) is always abnormal and shock Septic shock is a serious medical condition caused by decreased tissue perfusion and oxygen delivery as a result of infection and sepsis, though the microbe may be systemic or localized to a particular site. It can cause multiple organ dysfunction syndrome and death. Its most common victims are children, immunocompromised individuals, and the is often very rapid.
Other
- Noma Noma also known as cancrum oris or gangrenous stomatitis, is a gangrenous disease leading to tissue destruction of the face, especially the mouth and cheek is a gangrene of the face.
- Necrotizing fasciitis Necrotizing fasciitis , commonly known as flesh-eating disease or flesh-eating bacteria, is a rare infection of the deeper layers of skin and subcutaneous tissues, easily spreading across the fascial plane within the subcutaneous tissue affects the deeper layers of the skin.
- Fournier gangrene usually affects the male genitals and groin.
Treatment
Treatment is usually surgical debridement Debridement is the medical removal of a patient's dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. Removal may be surgical, mechanical, chemical, autolytic , and by maggot therapy, where certain species of live maggots selectively eat only necrotic tissue, with amputation necessary in many cases. Antibiotics alone are not effective because they do not penetrate infected muscles sufficiently.[citation needed]
History
As early as 1028, when antibiotics had not yet been discovered, fly True flies are insects of the order Diptera . They possess a pair of wings on the mesothorax and a pair of halteres, derived from the hind wings, on the metathorax maggots were commonly[citation needed] used to treat chronic wounds or ulcers to prevent or arrest necrotic spread, as some species of maggots consume only dead flesh, leaving nearby living tissue unaffected. This practice largely died out after the introduction of antibiotics, acetonitrile[citation needed] and enzyme to the range of treatments for wounds. In recent times, however, maggot therapy has regained some credibility and is sometimes employed with great efficacy in cases of chronic tissue necrosis.
Gallery
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Dry Gangrene with dead toes and visible bone of 85-year-old female (left leg). |
Severe Infection - Wet gangrene in center |
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Thu, 24 Jun 2010 18:33:16 GMT+00:00
Sify The Gujarat High Court Thursday asked the authorities to furnish a report on the condition of a convict who is suffering from gangrene allegedly due to lack ...
Larry J
Wed, 28 Jul 2010 12:34:46 GM
The group is called . Gangrene. and they are putting together an album on Decon Records Oct. 12. Features will include Raekwon, Guilty Simpson, Evidence, Roc C, MED, Planet Asia, Fashawn and more.
