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Type Of Gangrene In Diabetic Foot

Diabetic Foot Ulcerations & Problems | Gangrene

Diabetic Foot Ulcerations & Problems | Gangrene

Gangrene is a medical condition where there is tissue death in a certain area of the body. This occurs when there is reduced or an absence of blood supply to the affected area which can be a result of infection, vascular diseases such as peripheral arterial disease (PAD), or trauma. Gangrene can occur anywhere in the body but it occurs commonly at the feet where it is the easiest to have reduced or absent blood supply. Gangrene is one of the many complications of Diabetes. High blood sugar levels will cause damage to the nerves and blood vessels; there would be a loss of sensation and reduced blood supply to the feet, resulting in poor wound healing and being more prone to infection. This combination can lead to gangrene of the feet. There are several types of gangrene, with the two major types being dry and wet gangrene. Occurs when there is a disruption of blood supply to the tissues Affected area will appear red before turning brown and black Usually, the tissues will not be infected Occurs when there is a disruption of blood supply with infection to the tissues Continue reading >>

Gangrene: Causes, Symptoms, And Treatments

Gangrene: Causes, Symptoms, And Treatments

Gangrene is a condition that occurs when body tissue dies. It is caused by a loss of blood supply due to an underlying illness, injury, and/or infection. Fingers, toes, and limbs are most often affected, but gangrene can also occur inside the body, damaging organs and muscles. There are different types of gangrene and all require immediate medical attention. Blood plays a very important role in your health. Not only does it transport oxygen and nutrients throughout your body to feed cells, it delivers disease-fighting antibodies that protect your body from infection. When blood cannot travel freely throughout the body, your cells cannot survive, infection can develop, and tissue can die from gangrene. Any condition that affects blood flow increases your risk of gangrene, including: If you think you or a loved one may have sepsis, go to the emergency room immediately. Treatment for gangrene involves removing the dead tissue, treating and preventing the spread of infection, and treating the condition that caused gangrene to develop. The sooner you receive treatment, the better your chance of recovery. Depending on the type of gangrene, treatment may include: Surgery. Also called debridement, the dead tissue is surgically removed to prevent the spread of infection. In some situations, amputation (removal of the affected limb, finger or toe) may be required. Maggot therapy. Believe it or not, maggots still play a role in modern medicine. Maggots provide a non-surgical way to remove dead tissue. When used to treat gangrene, maggots from fly larvae (specially bred in a laboratory so they are sterile) are placed on the wound, where they consume the dead and infected tissue without harming healthy tissue. They also help fight infection and speed up healing by releasing substan Continue reading >>

[full Text] Autoamputation Of Diabetic Toe With Dry Gangrene: A Myth Or A Fact? | Dmso

[full Text] Autoamputation Of Diabetic Toe With Dry Gangrene: A Myth Or A Fact? | Dmso

Editor who approved publication: Professor Ming-Hui Zou Division of Vascular Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia Abstract: Diabetes is associated with various complications and reduced quality of life. Of the many complications, some are life-threatening. Among these, foot complications remain an important concern. The major foot complications include foot ulceration, cellulitis, abscess, wet gangrene, dry gangrene, and necrotizing fasciitis, with different pathophysiological concepts behind each of them. Gangrene occurs due to reduced blood supply in the body tissues that leads to necrosis. This condition may arise because of an injury, infection, or other health conditions, majorly diabetes. Gangrene is classified as dry, wet, and gas gangrene. In case of wet and gas gangrene, surgical amputation is usually performed to prevent the spread of infection to other tissues. In dry gangrene, due to the presence of clear demarcation, autoamputation is preferred in certain parts of the globe. The present review aims to analyze the mode of dry gangrene management in diabetic patients based on previous evidence and plans to highlight various management strategies available for dry gangrene and the advantages/disadvantages of different treatments with special consideration to autoamputation. Keywords: dry gangrene, amputation, surgical amputation, diabetic foot, diabetic toe, foot care Diabetes occurs due to impairment in either pancreatic production of insulin or utilization of the produced insulin. 1 It is one of the leading causes of deaths worldwide, the other causes being acquired immune deficiency syndrome, malaria, and tuberculosis. 2 With time, the worldwide prevalence of diabetes has increased more in the developing countries than in the develope Continue reading >>

Gangrene And Diabetes: Know The Facts

Gangrene And Diabetes: Know The Facts

Gangrene is a condition that occurs when your body tissue dies. This can happen when the blood flow to an area of the body is disrupted. Often, gangrene is the result of an injury or an infection of the skin and soft tissue. Gangrene typically affects the toes, fingers, and limbs. It can also affect your muscles or organs, but this isn’t as common. This condition is generally characterized by discolored skin, feelings of numbness, and unusual formation of discharge or pus. If you develop gangrene, you should seek immediate medical attention. Urgent care is needed to remove the dead tissue and prevent the bacteria from spreading through your bloodstream. If left untreated, gangrene can lead to a life-threatening infection. If you have diabetes, you have an increased risk of developing gangrene. High blood sugar levels can damage your nerves, which can cause a loss of sensation in the affected area. This can make it easier for you to develop an injury. High blood sugar can also affect your blood vessels and limit the blood flow to your feet. This causes a chain reaction. If your feet aren’t getting enough circulation, fewer infection-fighting cells are making their way to your feet. If you don’t have enough of these cells in the area, any wounds you develop can take longer to heal. Any potential wounds are also more likely to be infected. Check out: Tips for treating diabetic nerve pain » You’re most at risk for developing gangrene if you have an underlying medical condition that affects your circulation. There are several conditions that affect the blood vessels and can increase your risk, such as diabetes. Other conditions include: peripheral arterial disease atherosclerosis Raynaud’s phenomenon If you’ve recently had a surgery or experienced a traumatic in Continue reading >>

Gangrene

Gangrene

Gangrene refers to dead or dying body tissue(s) that occur because of inadequate blood supply. There are two major types of gangrene, wet gangrene and dry gangrene. Dry gangrene can result from conditions that reduce or block arterial blood flow such as diabetes, arteriosclerosis, and tobacco addiction as well as from trauma, frostbite, or injury. Wet gangrene can result from the same causes as dry gangrene but always includes infection. In some cases of wet gangrene, the initial cause is considered to be the infection. Treatment for all cases of gangrene usually involves surgery, medical treatment, supportive care, and occasionally, rehabilitation. What is the difference between wet and dry gangrene? Wet (also sometimes termed "moist") gangrene is the most dangerous type of gangrene because if it is left untreated, the patient usually develops sepsis and dies within a few hours or days. Wet gangrene results from an untreated (or inadequately treated) infection in the body where the local blood supply has been reduced or stopped by tissue swelling, gas production in tissue, bacterial toxins, or all of these factors in combination. Additionally, conditions that compromise the blood flow such as burns or vascular trauma (for example, a knife wound that cuts off arterial flow) can occur first. Then the locally compromised area becomes infected, which can result in wet gangrene. Wet gangrene is the type that is most commonly thought of when the term gangrene is used. Wet gangrene often produces an oozing fluid or pus, hence the term "wet." Early stages of wet gangrene may include signs of infection, aching pain with swelling, a reddish skin color or blanched appearance if the area is raised above level of the heart, coolness on the skin surface, ulceration, and a crackly se Continue reading >>

Type 1 Diabetic Foot Complications

Type 1 Diabetic Foot Complications

The Journal of Diabetic Foot Complications, 2016; Volume 8, Issue 1, No. 3, Pages 17-22 © All rights reserved. Authors: Amit Kumar C. Jain, MBBS, D.DIAB, F.DIAB, DNB, FPS* Abstract: Diabetic foot problems are an unfortunate complication of diabetes, and their incidence is increasing worldwide. Diabetic foot ulcers (DFU) affect 15% of patients with diabetes during their lifetime. For years DFUs have been commonly categorized through the Wagner classification. Recently, a new diabetic foot classification was proposed that evaluates the diabetic foot beyond ulceration. This classification includes all the common diabetic foot complications seen in day-to-day practices. Just the way diabetes mellitus is classified into Type 1 diabetes mellitus, Type 2 diabetes mellitus, and others, this new diabetic foot classification categorizes diabetic foot complications into three simple types. This study highlights various Type 1 diabetic foot complications seen in our practice, and represents the first time this type of study is presented in the literature. Key words: Abscesses, Diabetic Foot, Necrotizing Fasciitis, Wet Gangrene Corresponding author * Amit Kumar C. Jain, MBBS, D.DIAB, F.DIAB, DNB (General Surgery), FPS (Podiatric Surgery) Consultant General Surgeon, Diabetic Lower Limb and Podiatric Surgeon Assistant Professor Department of Surgery St John’s Medical College Bangalore, India 560034 Email: [email protected] INTRODUCTION Diabetes is one of the major non-communicable diseases affecting people worldwide, and it is one of the most challenging health problems in the 21st century.1 The number of people with diabetes worldwide was estimated at 131 million in 2000; it is projected to increase to 366 million by 2030.2 Approximately 3.1 million people in England have di Continue reading >>

Diabetic Foot Ulcers: Pathogenesis And Management

Diabetic Foot Ulcers: Pathogenesis And Management

Foot ulcers are a significant complication of diabetes mellitus and often precede lower-extremity amputation. The most frequent underlying etiologies are neuropathy, trauma, deformity, high plantar pressures, and peripheral arterial disease. Thorough and systematic evaluation and categorization of foot ulcers help guide appropriate treatment. The Wagner and University of Texas systems are the ones most frequently used for classification of foot ulcers, and the stage is indicative of prognosis. Pressure relief using total contact casts, removable cast walkers, or “half shoes” is the mainstay of initial treatment. Sharp debridement and management of underlying infection and ischemia are also critical in the care of foot ulcers. Prompt and aggressive treatment of diabetic foot ulcers can often prevent exacerbation of the problem and eliminate the potential for amputation. The aim of therapy should be early intervention to allow prompt healing of the lesion and prevent recurrence once it is healed. Multidisciplinary management programs that focus on prevention, education, regular foot examinations, aggressive intervention, and optimal use of therapeutic footwear have demonstrated significant reductions in the incidence of lower-extremity amputations. Foot disorders such as ulceration, infection, and gangrene are the leading causes of hospitalization in patients with diabetes mellitus.1,2 Approximately 15 to 20 percent of the estimated 16 million persons in the United States with diabetes mellitus will be hospitalized with a foot complication at some time during the course of their disease.3 Unfortunately, many of these patients will require amputation within the foot or above the ankle as a consequence of severe infection or peripheral ischemia. Neuropathy is often a pr Continue reading >>

Diabetic Foot Infections

Diabetic Foot Infections

Author: Michael Stuart Bronze, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP more... Compromise of the blood supply from microvascular disease, often in association with lack of sensation because of neuropathy, predisposes persons with diabetes mellitus to foot infections. These infections span the spectrum from simple, superficial cellulitis to chronic osteomyelitis. The radiograph below demonstrates a foot lesion in a patient with diabetes. Chronic diabetic ulceration with underlying osteomyelitis. Plain film radiograph exhibiting cortical disruption at the medial aspect of the first MTP joint. Diabetic foot infections typically take one of the following forms: Tender, erythematous, nonraised skin lesions are present, sometimes with lymphangitis Lymphangitis suggests group A streptococcal infection Bullae are typical of Staphylococcus aureus infection, but occasionally occur with group A streptococci The patient may be acutely ill, with painful induration of the soft tissues in the extremity In mixed infections that may involve anaerobes, crepitation may be noted over the afflicted area Extreme pain and tenderness may indicate compartment syndrome or clostridial infection (ie, gas gangrene) The tissues are not tense, and bullae may be present Unless peripheral neuropathy is present, the patient has pain at the site of the involved bone Usually, fever and regional adenopathy are absent The patient's temperature is usually less than 102F Pain may or may not be present, depending on the degree of peripheral neuropathy Deep, penetrating ulcers and deep sinus tracts (diagnostic of chronic osteomyelitis) are usually located between the toes or on the plantar surface of the foot The medial malleoli, shins, or heels are not usually sites of involvement See Clinical Presen Continue reading >>

Gangrene

Gangrene

For other uses, see Gangrene (disambiguation). Gangrene is a type of tissue death caused by not enough blood supply.[4] Symptoms may include a change in skin color to red or black, numbness, swelling, pain, skin breakdown, and coolness.[1] The feet and hands are most commonly involved.[1] Certain types may present with a fever or sepsis.[1] Risk factors include diabetes, peripheral arterial disease, smoking, major trauma, alcoholism, HIV/AIDS, frostbite, and Raynaud's syndrome.[3][4] It can be classified as dry gangrene, wet gangrene, gas gangrene, internal gangrene, and necrotizing fasciitis.[3] The diagnosis of gangrene is based on symptoms and supported by tests such as medical imaging.[6] Treatment may involve surgery to remove the dead tissue, antibiotics to treat any infection, and efforts to address the underlying cause.[5] Surgical efforts may include debridement, amputation, or the use of maggot therapy.[5] Efforts to treat the underlying cause may include bypass surgery or angioplasty.[5] In certain cases hyperbaric oxygen therapy may be useful.[5] It is unknown how commonly the condition occurs.[2] Signs and symptoms[edit] An illustration showing four different stages of gangrene, including one (Fig. 4 top right) caused by an obstacle to the return of the venous blood due to heart disease. Symptoms may include a change in skin color to red or black, numbness, pain, skin breakdown, and coolness.[1] The feet and hands are most commonly involved.[1] Causes[edit] Gangrene is caused by a critically insufficient blood supply (e.g., peripheral vascular disease) or infection.[3][7][8] It is associated with diabetes[9] and long-term tobacco smoking.[4][3] Dry[edit] Dry gangrene is a form of coagulative necrosis that develops in ischemic tissue, where the blood supply Continue reading >>

Gangrene And Diabetes

Gangrene And Diabetes

The first symptoms of gangrene should be reported to your doctor immediately Gangrene is a state in which a certain part of the body is not getting sufficient blood circulation, causing the tissue to die. The condition is split into two categories: Wet and Dry Gangrene. Redness in the affected area, which can then become brown or black Dry gangrene is the type of gangrene that can occur as a complication of a pre-existing health condition, including type 1 and type 2 diabetes . As a result of damage to the blood vessels throughout the body due to prolonged hyperglycemia , it is possible for blood circulation to be cut off. Blood carries oxygen and nutrients to the tissue around the body and so without it, the tissue will eventually die. This usually happens in the extremities first, in the toes, feet and fingers. Gangrene that is caused by an infection of some sort is known as wet gangrene. It occurs after an injury that gets infected, such as a burn or frostbite. Swelling from the body fighting off an infection can cause a loss of blood circulation that can starve a section of the body of oxygen and nutrients and cause gangrene. This type of gangrene is more of a threat to people with diabetes who have an impaired immune system as their bodies are less able to fight off bacteria, virusesand other types of infection. Furthermore, gangrene infections can occur at the site of foot ulcers , which is a common complication of both type 2 and type 1 diabetes . Wet gangrene is the more rapid of the two types and can lead to septic shock. Extreme cases of gangrene may have to result in amputation , which is why it is important to be aware of the signs of gangrene so that it can be treated at an early stage. Other methods of treating less severe cases include: Surgery - Gangren Continue reading >>

What You Need To Know About Gangrene

What You Need To Know About Gangrene

Gangrene happens when a lack of oxygen-rich blood causes tissue to die in some part of the body, often the hands or feet. It is a serious condition that can result in amputation of a limb or death. It needs urgent treatment to halt the spread of tissue death as rapidly as possible. Diabetes is linked to gangrene. Diabetic neuropathy, or nerve death, can mean that a person has an injury and does not notice it. Diabetes also affects the small arterial vessels and they become insufficient to supply the extremity. Other risk factors are smoking and conditions such as Raynaud's disease. Here are some key points about gangrene. More detail is in the body of this article. Gangrene occurs when a lack of blood supply, and therefore oxygen, results in tissue death. Gangrene is usually external, affecting the extremities, but it can also affect internal tissues. Surgical complications can lead to internal gangrene, with signs of toxic shock. Urgent treatment is important to prevent further serious illness and death. This includes removal of dead tissue and sometimes amputation. What is gangrene? The two main forms of gangrene are known as dry and wet gangrene. Other types, such as Fournier's gangrene and internal gangrene, are less common. Dry gangrene Dry gangrene is sometimes called mummification. It starts more slowly than wet gangrene, and it is most commonly associated with chronic disease, including diabetes. The skin becomes dry, shriveled, and usually dark in color, ranging from brown to purplish-blue and feels cool or cold to touch. Wet gangrene In wet or moist gangrene, the skin swells and blisters form and may rupture. Pus may appear. It is generally associated with infection of the dead tissue. Wet gangrene can develop following a severe burn or frostbite. This type of Continue reading >>

Causes And Risks Of Gangrene In Diabetes Patients

Causes And Risks Of Gangrene In Diabetes Patients

An arterial blood clot, athersclerosis, and smoking are all caused of dry gangrene. High blood sugar over time damages the blood vessels, which increases the risk of developing dry gangrene if you have diabetes. Wet gangrene, the most common type of gangrene, is a result from an untreated or poorly treated infections and can occur when a condition compromises blood flow. General causes can include: burns, vascular trauma (for example, a knife wound, gunshot wound, traumatic accident). In people with diabetes, wet gangrene can develop at the site of foot ulcers . where b acterial infections breed as the germs invade the tissues. Having diabetes can impaire your immune system and make it more of a threat as you are more likely to be unable to fight off an infection in your feet or other tissues. As the infection causes swelling, it can cut off blood circulation and this leads to the tissues dying. It can progress rapidly. If it is not treated, there is a risk of developing septic shock, which can be deadly. This type of gangrene is most often caused by the Clostridium perfringens bacteria, which produces gas and toxins. It can cause gangrene anywhere in the body, sometimes deep in the organs. Gas gangrene can develop after surgery or trauma. Risk factors for gas gangrene includediabetes, atherosclerosis , and colon cancer . It can develop suddenly and progress swiftly. This condition often requires emergency action to prevent shock, kidney failure , coma , and death. Internal gangrene can affect your inner tissues and organs, without presenting symptoms on the skin or limbs. Common symptoms of internal gangrene include, pain, unexplained fever that lasts a long time, or low blood pressure. You may also experience confusion. This can occur, for example, when your intestin Continue reading >>

Treatment

Treatment

Treatment for gangrene involves removing the affected tissue, preventing infection or treating any existing infection, and treating the problem that led to gangrene developing. For example, if gangrene is caused by a poor blood supply, surgery may be used to repair damaged blood vessels. If gangrene is caused by an infection, strong antibiotics may be used as well as surgery. Removing dead tissue Surgery to cut out the dead tissue, known as debridement, is often necessary to prevent the gangrene from spreading and to allow the surrounding healthy tissue to heal. Larval debridement therapy (biosurgery) In some cases, it may be possible to use larval debridement therapy, also known as biosurgery, instead of conventional surgery to remove the dead tissue. Certain types of fly larvae are ideal for this because they feed on dead and infected tissue but leave healthy tissue alone. They also help fight infection by releasing substances that kill bacteria and stimulate the healing process. Maggots used for larval therapy are specially bred in a laboratory using eggs that have been treated to remove bacteria. The maggots are placed on the wound and covered with gauze, under a firm dressing, which keeps them on the wound (and out of sight). After a few days, the dressing is cut away and the maggots are removed. Medical studies have shown larval debridement therapy can achieve more effective results than surgical debridement. However, because of the nature of this type of treatment, many people are reluctant to try it. Amputation In severe cases of gangrene, where a whole body part, such as a finger, toe, or limb, is affected and debridement is unlikely to help, amputation may be considered. Amputation can prevent gangrene spreading to other parts of the body and can be used to re Continue reading >>

Causes

Causes

Gangrene can develop when the supply of blood to one or more areas 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: diabetes – a lifelong condition that causes a person's blood sugar level to become too high, which can damage nerves and blood vessels (see below) atherosclerosis – where arteries narrow and become clogged with a fatty substance known as plaque peripheral arterial disease – where a build-up of fatty deposits in the arteries restricts blood supply to leg muscles Raynaud's phenomenon – where blood vessels in certain parts of the body, usually the fingers or toes, react abnormally to cold temperatures As blood vessels are naturally narrow, any damage or extra narrowin Continue reading >>

Diabetes And Gangrene

Diabetes And Gangrene

Diabetes mellitus is a condition where the body is unable to control the blood sugar. Normally the body has a good immune system that fights against microbes and invading organisms that may lead to infections. The white blood cells are the main fighters in this respect to keep the body protected. (1-5) In patients with diabetes, the immune system of a person is affected. In addition, the blood vessels are damaged due to the excessive blood sugar running in the veins. Peripheral neuropathy and gangrene Also diabetes leads to damage to the nerves in the long run. This is called peripheral neuropathy. This leads to lack or decreased pain sensation. So if a diabetic patient gets accidentally poked, hurt, cut or burnt especially in the limbs or extremities like toes and fingers he or she may not be aware because the cut may not hurt. Pain usually alerts a normal person to care for a hurt area in order to prevent infections. In diabetics this is absent and the wound often gets infected. Diabetes and the immune system Further diabetes weakens the immune system which is unable to fight the invading organisms at the wound. High blood sugar makes the blood more favourable for bacterial and microorganisms to grow. Foot infections in diabetics In diabetics the common sensitive areas affected are lungs, skin, feet, urinary tract, genital area and mouth. In diabetics skin infections are detected commonly because of their visibility and not because of their pain. Diabetics commonly get foot infections. This is because the feet are commonly exposed to injury and bumps and bruises in the activities of daily living. Foot infections may begin as small ulcers and may invade deeper tissues, lead to gangrene or affect the bones and invade the blood stream as well. It is found that nearly hal Continue reading >>

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