Dry gangrene may be a late complication of diabetes. Arteriosclerosis may be a precursor to dry gangrene (Anderson & et al. 1998). Wet gangrene, usually occurring in internal organs, is caused by liquefactive necrosis which is a result of neutrophils invading the site (Huether & McCance, 2008). Gas gangrene results from infection of tissue that is injured (Huether & McCance, 2008). The infective bacteria, a strain of clostridium, can be fatal if the enzymes lyse erythrocyte membranes (Huether & McCance, 2008). This may result in decreased oxygenation which may lead to shock which may lead to death (Huether & McCance, 2008). According to Mayo clinic, Fournier’s gangrene, uncommon and usually occurring in men, results from genital infection or urinary tract infection (2007).
Dry gangrene typically presents with a cold, dry, shriveled appearance and may eventually turn black (Anderson & et al. 1998). Wet gangrene is characterized with a cold, swollen, and black appearance; a foul odor is usually present (Huether & McCance, 2008). Gas gangrene is characterized by destroyed connective tissue, destroyed cellular membranes, and bubbles of gas in the muscle cells (Huether & McCance, 2008). The common symptoms that occur with gangrene are fever, slow wound healing, foul smelling wound discharge, and pale, cold, hard, possibly numb skin according to the Mayo clinic website (2007).
The mayo clinic website advises lab work (specifically white blood cell count) to assess for infection, x-ray, CAT scan, magnetic resonance imaging, arteriogram to evaluate artery patency, and fluid/tissue cultures to assess for gangrene (2007). For extensive cases, exploratory surgery may be necessary to evaluate and treat gangrene (Mayo 2007). The treatment suggested by Mayo clinic consists of surgery, antibiotic therapy, skin grafting, amputation, and hyperbaric oxygen therapy (2007). Hyperbaric oxygen therapy consists of the patient being placed in a chamber with high oxygen pressure. The high pressure will promote rich oxygenation of the blood which should inhibit bacterial growth and promote healing (Mayo 2007). Continued patient monitoring, supportive therapy, Wound hygiene with soap and water are steps to maintain optimal healing.
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