Gangrene

Any injury can result in tissue death or necrosis. Gangrene is a type of necrosis but on a larger scale. Gangrene results from tissues losing access to nutrients and oxygen supplying blood circulation -- commonly in extremities such as fingers, toes, hands, or feet. Blood circulation can be lost or cut off by different means, especially by injury, arteriosclerosis, infection, thrombosis, diabetes, or long-term smoking damage. While gangrene of an extremity is not likely to be misdiagnosed, catching it and treating it in time to save bodily tissues or one’s life can be the hardest part, depending on the type of gangrene it is. The type of gangrene that is harder to diagnose is one of internal organs such as the intestines.

Different types of gangrene are dry, wet, and gas gangrenes. Some are also further classified or named depending on the location of the body affected or if a specific type of bacteria is involved.

• Dry gangrene results from arterial occlusion, or a loss of circulation to an area. Dry gangrene does not have bacterial involvement. This makes it much easier to recover from. While tissue loss still happens, the possibility of spreading or sepsis is not as much of a concern. Infection is still a concern, however, as sloughing tissue can leave openings for bacteria. Dry gangrene starts as numbness or coldness in affected areas (especially extremities). Discoloration begins to happen as blood is no longer perfusing the tissues. The flesh will start to look pale (bluish), turning to a reddish/brown, and finally to black. The look of flesh affected by dry gangrene is often said to have a mummified appearance as it shrinks and eventually sloughs off. If the tissue does not fall off on its own (also known as auto-amputation), then it may be removed surgically (known as debridement or amputation).

• Wet gangrene results from loss of circulation and has bacterial involvement. It requires prompt medical intervention to prevent infection from becoming systemic. Bed sores or pressure sores are a type of wet gangrene. With wet gangrene, the cardinal signs of inflammation will be present -- redness, swelling, pain, and fever. Other symptoms are the presence of fluid oozing from the wound (thus the term wet), blackening of the affected flesh, and a bad odor. Wet gangrene can progress to gas gangrene if not treated quickly and aggressively.

• Gas gangrene, like wet gangrene also includes bacterial infection. Gas gangrene infections result in death to a significant percentage of people who are infected as bacterial infection is systemic with this type of gangrene. It progresses rapidly as swelling and gas bubbles from bacterial respiration cuts off circulation to more and more tissues. Black bubbles of gas can be seen erupting under the skin's surface. this type of gangrene is very serious, requiring prompt hospitalization and aggressive treatment to prevent not only tissue loss but death from sepsis.

Treatments for gangrene can include antibiotics, amputation, vascular surgery (to repair and hopefully restore circulation to affected areas), maggot therapy (the larvae are sometimes used for debridement as they eat only dead tissues), hyperbaric oxygen therapy (for cases of gas or wet gangrene, excess oxygen is used with the hope of bringing anaerobic bacteria under control). The prognosis of wet or gas gangrene is dependent on the amount of tissue affected (or how fast help was sought for infection), the person’s overall health, and the type of bacteria involved.

Misdiagnosis of gangrene can happen especially in cases of internal organs. Strangulation of portions of the intestines can result in internal gangrene. Prompt diagnosis and treatment are necessary to prevent the spread to neighboring organs or systemic infection.

If you or a loved one suffered a worsening of a condition due to misdiagnosed gangrene, or a failure to diagnose gangrene, you may be eligible for damages. Call the Sweeney Law Firm and let our experts review the facts. You may have a medical malpractice case. If we decide to accept your case, we work on a contingency fee basis, meaning there is no fee for representation unless there is a settlement or fund recovery made on your behalf.