Gangrene

You may have seen the lurid headlines about “flesh-eating bacteria” in recent years. Despite the hype, this type of gangrene caused by strep bacteria is rare. However, other types are all too common. We want you to be able to recognize risk factors and symptoms, because catching the problem early gives you the best chance of keeping all your fingers and toes about you.

The Progression to Tissue Death

Gangrene doesn’t just pop up out of nowhere. It results from a bacterial infection (often strep, staph, or clostridia strains) or lack of blood supply to your skin and other tissue, and usually starts with an injury or disease.

Here’s a common example: You have diabetes, and the uncontrolled glucose levels have damaged the blood vessels in your feet (peripheral arterial disease—PAD). Because of the plaque buildup, your feet don’t have good circulation anymore.

Then you make the mistake of walking around barefoot and step on that plastic building block your grandchild left on the floor. However, you don’t feel the cut on the ball of your foot, because high blood sugar levels have also damaged your nerves. Bacteria enter the wound, and poor blood flow makes it hard to fight them off.

The infection spreads and begins to completely block blood flow to some of the cells. When cells can’t get oxygen, they die. The tissue death spreads the longer you go without treatment, and eventually could require an amputation to save your limb.

How to Recognize Gangrene

Knowing what gangrene looks like can mean getting help soon enough to stave off serious damage. There are three types. You may have one or more of the following symptoms with wet gangrene:

  • Change in skin color. The infected skin can be pale or white, red, blue or purple, or black. It depends partly on the type of infection and partly on how far it has developed.
  • Definite borders. There will be a noticeable line between normal skin and the affected area.
  • Pain, and then nothing. In the early stages, your discomfort may be severe, but as the tissue dies, the area may just feel numb, because the nerves are not working anymore.
  • Discharge or pus that smells. The sore will leak fluids that have a foul odor.

Dry gangrene results not from a wound but from blocked arteries (from conditions like diabetes or arteriosclerosis). In this case, the first symptoms may be coldness and numbness, and the tissue death is more gradual. The skin turns red, and then brown, and eventually black as the tissue shrivels and drops off.

The third type is called gas gangrene, and is related to Clostridia bacteria which give off toxins and poisons that kill the tissue. The wound may swell and develop blisters and have a brown or bloody discharge. Extreme pain is not uncommon, and if the infection moves into the bloodstream you may have fever and an increase in respiration and heart rate.

Don’t Ignore Gangrene Symptoms!

At the first appearance of these symptoms, make an appointment at Sierra Foot & Ankle for prompt evaluation and care of your infected foot. The gas type especially needs immediate and aggressive treatment to keep the infection from spreading in your blood stream and damaging organs.

The wet type requires surgical debridement of the wound (removal of dead tissue) and treatment with antibiotics, and if you have the dry type, we will need to evaluate your vascular problems and find ways to increase blood flow to the damaged tissue. Sometimes that will involve surgery to restore blood flow.

Dr. Victoria Melhuish is a foot doctor and experienced surgeon in Carson Valley who can deal with all of your foot issues—including infection and tissue death. Call Sierra Foot & Ankle in Carson City or Gardnerville, NV at (775) 783-8037. You can also use our online contact form to schedule.