Gangrene and Its Treatments
Gangrene is the death of tissue, often resulting from an obstruction in the blood supply to the tissue. The blood that feeds your tissues provides oxygen, nutrients that feed your cells and immune system, without a proper blood supply, your cells can't survive. Gangrene most commonly affects the extremities, including your toes, fingers and limbs, but can also occur in the muscles and in iinternal organs.
Three Major Types of Gangrene:
a. Dry gangrene:
It is a condition of gangrene that results when one or more arteries become obstructed, in this type of gangrene, the tissue slowly dies because of inadequate or no blood supply. This occurs mostly in the extremities and it may develop in people with diabetes or advanced hardening and narrowing of the arteries. It may also develop after prolonged exposure to freezing temperatures.
Symptoms of dry gangrene:
In dry gangrene, the tissue first becomes bluish and they feel cold to the touch. As time progresses, a line of demarcation appears between the healthy and devitalized tissue, which becomes dry and black. Eventually, there may be a separation of the dead tissue from the living tissue, with spontaneous amputation of the involved extremity. If the gangrene does not affect an entire extremity, the gangrenous area may separate and slough off, leaving an ulcer in the skin.Treatment of dry gangrene:Treatment of this type of gangrene is aimed at improving circulation to the affected area. This may be accomplished with drugs or through the surgical removal of the obstruction.b. Moist, or wet, gangrene:It is caused by certain bacterial infection. It can develop following a severe burn, frostbite or injury. When blood flow stops, bacteria begin to invade the muscle and thrive, multiplying quickly without interference from the body's immune system. It often occurs in people with diabetes who unknowingly injure a toe or foot.Symptoms of Moist or Wet Gangrene:The affected area becomes swollen, discolored, and often foul smelling.Treatment of Moist or Wet Gangrene:Administration of antibiotics and sometimes the surgical removal of the dead tissue to keep the infection from spreading.c. Gas gangrene:It is an infection caused by certain bacteria of the genus Clostridium. These bacteria live in the soil and thrive in an atmosphere that is low in oxygen. The huge majority of gas gangrene cases occur as complications of bad wounds, particularly ones that are contaminated with dirt.Symptoms of Gas gangrene:After an incubation period of one to four or five days, the affected tissue is swollen, painful and cold. A watery, brownish, foul-smelling fluid drains from the wound, and little bubbles of gas develop in the tissues.Treatments of Gas gangrene:Gas gangrene is often treated with the antitoxin for clostridium. In a number of cases, amputation may have to be used to keep the infection under control. Severe cases have been treated by keeping the patient in an oxygen-rich atmosphere, as in a hyperbaric chamber. In hyperbaric oxygen (HBO) therapy the patient is placed in a pressurized chamber and receives 100% pure oxygen to breathe. This has been shown useful in inhibiting the production of toxins in gas gangrene and for getting oxygen quickly to tissues. Other Less Common Type of Gangrene:d. Internal gangrene:This type of gangrene can affect one or more of your organs, most commonly the intestines and gallbladder.e. Fournier's gangrene:It is the most rare type of gangrene, it involves the genital organs. Men are most often affected, but women can develop this type of gangrene as well. This usually occurs due to an infection in the genital area or urinary tract. Symptoms includes; genital pain, tenderness, redness and swelling.
TREATMENT:
Chelation therapy:It is a treatment which uses an intravenous solution containing the drug ethylenediamine tetra-acetic acid (EDTA), among other substances. In the bloodstream, EDTA binds and removes toxins and plaque formation on arterial walls. It therefore promotes circulation throughout the body and may help reverse the processes leading to gangrene.
how long do you wait to slough off there is line of clear demarcation it has been four months
ReplyDeleteI am sorry I should have been more clear I am talking about my mom 83yrs had aneurysm surgery (T3A) on may 6th 09 before this she had really normal life of a 83yrs old with week kidney and week heart.
ReplyDeleteThen after surgery no chance to survivor was in ICU for 4weeks with kidney failure having dialysis every 2 days respirator for lungs not conscious at all and all left toes blue. later in 4wks she started gaining conscious and they put trac (tracostomy) on her neck in 5wks she was moved from ICU to long term care, still had trac and dialysis going and the toes had turn brown, Dr had ordered to put nitrate patches on her left foot, we kept on telling the Dr about the toes they said not to worry they will fall off lets worry to stabilize her lungs and kidney.
Long story short things started getting better and mom was released from hospital on July 2nd 09 with kidneys reverse(no dialysis)and trac removed, but her dry gangrene was more dry and the Dr said as she gets stronger go for amputation or it may fall off as of today sept20th 09 she is still not that strong pulmarologist says her lungs are scar badly from pneumonia (twice she got in hospital) she is on nebulizer and most cautious so on regen diet (nephrologists says what ever you are doing her counts are good just keep it up we do not want to take chances on kidneys),and still weak heart.
Now Dr are making us scared that we are waiting too long ,the toes might get infected and you will end up loosing till the knee do it now till the mid foot(big tarcels)when it's dry and there is a clear line of demarcation. So we took orthopedic surgeon’s app did the whole nine yards and then they come up with whole lots and lots of risk with age ,weak heart, kidneys and lungs(to regulate breathing they might give general enestasia)Dr still say it might fall off, but when and which toe ,what if any one gets infected you will have to go for surgery then what in emergency it's going to be more risk.
She is getting well to do stuff on her own with all physical, respiratory and occupational therapists, walking, talking, eating, going to church I am really confused should I let her live this way and wait till it falls off(I don't even know how painful it might be when the dry toes even start falling),then if infected go for surgery or risk everything right now where I might loose her or even if not she might not come out clean with her weak organs, which except nebulizer and dry gangrene she is clean out(no trac or dialysis) please want to know how long she can live with dry gangrene without surgery.