Dry gangrene (or gangrene) is a rather rare condition in which parts of the body begin to dry out and turn black over time due to a lack of blood flow. In severe cases, the skin and tissues can also peel off. Dry-type gangrene is different from others because it is not accompanied by infections caused by burns or trauma, which prevent some parts of the body from receiving normal blood flow, and it also does not have secretions of pus or other liquids. It usually affects the extremities of the body, especially the hands and feet, although it can also develop on the limbs, muscles and even internal organs. People with systemic conditions, such as diabetes, peripheral arterial disease, or an autoimmune disease are at increased risk of developing this form of gangrene.
Steps
Part 1 of 3: Changing the Lifestyle
Step 1. Stop smoking
If you get rid of this habit, you can prevent gangrene from developing and progressing, as smoking promotes the slow process of interrupting blood flow to the blood vessels. When the blood stops flowing, the tissues die, causing gangrene. You must avoid any element that contributes to the interruption of circulation and among these there is undoubtedly also smoking.
- The active substance present in cigarettes, nicotine, is the element that most affects blood vessels because it constricts them, consequently slowing the flow. If one part of the body receives less blood, it also gets less oxygen, and prolonged tissue hypoxia causes necrosis (death), leading to gangrene.
- Smoking is also associated with various vascular disorders that can cause blood vessels to narrow and harden.
- You should quit smoking gradually, or you may suffer from severe withdrawal symptoms that make it more difficult to stick to your commitment.
- Ask your doctor to help you quit.
Step 2. Change your diet
In case of gangrene, the tissues and muscles are damaged due to limited blood circulation. Therefore, you should eat foods that are high in protein and calories to help with their healing. Protein can also replenish damaged muscles, while nutrient-rich foods (unlike junk food and empty calorie foods) provide the body with the energy to restore organ function.
Foods high in protein but low in fat to avoid clogging of the arteries include turkey, fish, cheese, lean pork and beef, tofu, beans, eggs and peanuts. Avoid fatty foods, such as red meat, butter, lard, aged cheese, cakes, cookies, and fried foods. Instead, try incorporating more dark green leafy vegetables into your diet
Step 3. Supplement your diet with foods rich in germanium and other antioxidants
Germanium is indeed an antioxidant and is believed to be able to increase oxygen activity in the body, although much of this evidence is still anecdotal. It also appears to strengthen the immune system and have anticancer properties.
- Foods rich in this element include garlic, onion, shiitake mushrooms, whole wheat flour, bran, ginseng, green leafy vegetables and aloe vera.
- Since there is no reliable scientific data regarding the effectiveness of germanium on the flow of oxygen to the tissues of a person with dry gangrene, a precise dosage or amount cannot be recommended either. Talk to your doctor for his opinion and discuss with him the advisability of consuming more germanium for your particular situation.
Step 4. Check how much sugar you are consuming
While this is good advice for anyone, it is even more important for those with diabetes. Diabetic people should reduce their sugar consumption to keep their blood sugar within acceptable levels that depend on meal planning, physical activity and time of day. They also need to constantly monitor the extremities of the body for cuts, redness, swelling, or infections.
Patients with diabetic neuropathy should check themselves daily for symptoms, such as numbness in the arms, legs, fingers or toes, as these are all signs of poor circulation. High sugar consumption is related to hypertension, which affects normal blood circulation
Step 5. Limit your alcohol intake
Drinking a lot, beyond the recommended daily limits, can cause hypertensive spikes and raise cholesterol levels which, in turn, can cause blockages in the blood flow.
Women should limit themselves to one drink per day, while men can drink two at most. Consider that a drink is equivalent to a beer (340ml), a glass of wine (150ml) or a 45ml spirits
Step 6. Exercise
Although the effects of physical activity on the development and treatment of dry gangrene are not known, it can actually mitigate some underlying diseases that induce its formation. For example, in one study it was found that performing scheduled and monitored exercise on a treadmill for 30-40 minutes, three or four times a week, improves limp symptoms or painful leg cramps due to lack of blood in the muscles. of the lower limbs.
Try to engage in a regimen of moderate exercise at home, whether it's walking on the treadmill or around the block. Keep a walking diary of your physical activities and any symptoms or signs present. Consult your doctor before starting an exercise program if you have heart problems or other medical conditions
Step 7. Do specific exercises limited to the limbs
If you are unable to move independently, you can do passive movements limited to the range of joint motility. To perform these exercises you need someone to help you stimulate the joints throughout their range of motion with a regular frequency, to avoid muscle contractures (permanent shortening of the joints and muscles) and to improve blood circulation in some specific areas of the body. These exercises include:
- Head exercises, such as rotations and forward bends.
- Exercises for the shoulders and elbows that involve bending the elbows, raising and lowering the arms and moving them sideways.
- Exercises for the forearms and wrists, such as pushups, rotations, and lifts.
- Finger and hand exercises where you have to bend, spread and rotate your fingers.
- Exercises for the hips and knees. In this case you have to flex your hips and knees, rotate your legs and move them sideways.
- Exercises for the feet and ankles: push-ups, rotations, lateral movements of the ankles, push-ups and stretches of the toes.
Step 8. Heal any wounds
You need to pay attention to any sore or burn, especially if you are diabetic, otherwise it could become incurable. Regardless of whether you already have gangrene or are worried that it may develop, the most important thing to do is to keep any wound clean and protected as the body tries to rebuild the capillary bed under the scab, or eschar. Here's how to do it:
- Clean the wound with povidone iodine or hydrogen peroxide and apply an antibiotic cream.
- After cleaning it thoroughly, cover it with a sterile gauze or bandage and a clean cotton sock. Cotton absorbs moisture away from the wound, facilitates air circulation and therefore healing.
Step 9. Apply cayenne pepper tincture, garlic, honey, or onion to the lesions
Cayenne Pepper Tincture is a liquid pepper extract that reduces pain, improves the circulatory system and reduces the risk of infections. You can buy it in the pharmacy closest to home. Apply it to the affected areas two or three times a day or as directed by your doctor.
- You can also crush a few cloves of garlic and apply them directly to the wounds. This remedy was widely used during the First and Second World Wars, because garlic has antimicrobial properties, which help prevent or treat gangrene infections, but also antiplatelet effects that break down the clots in the veins that can cause this disorder.
- Alternatively, you can apply a compress of chopped onions to the affected areas. To prepare it, slice an onion and use it to cover the wound with a clean cloth. Leave it in place for 5-10 minutes and repeat several times a day. This remedy is supposed to improve blood circulation in these painful areas.
- Try applying honey. It has been used for a long time to treat burns, wounds and ulcers. Studies are still being done on this, but it is known that this food has antibacterial properties. Make sure you use one that is sterilized and lab tested. Spread some on gauze or bandage and apply it directly to the wound. You can also find tampons already soaked in honey on the market.
Part 2 of 3: Medical Treatments
Step 1. Undergo surgery to remove dead tissue
Surgery is needed when the gangrene has reached a severe stage and dead tissue needs to be removed. The amount that must be removed depends on how much blood has supplied the area and where the necrotic tissues are located. This is standard procedure for dry gangrene. The main types of interventions for this pathology are the following:
- Skin debridement. This procedure consists of removing the tissues affected by gangrene and which are rotten. Sometimes the removed skin is replaced with other healthy skin layers (in this case we speak of skin transplantation).
- Amputation. If the tissue has died completely and other medical or surgical procedures have not allowed the affected area to be recovered, the limb or other parts of the body must be amputated to prevent the gangrene from spreading to surrounding areas or other areas of the body. This surgery is performed when skin debridement has not been beneficial. Unless there is an imminent danger of death, remember that in most cases the decision to amputate is only made after a thorough and extensive consultation with the doctor and after obtaining all the information, in order to make a choice. aware.
Step 2. Consider larval therapy
Also known as therapy, it is an alternative to surgery that works in a similar way to the removal of dead tissue. This is not a surgical procedure; in this case the fly larvae are used, positioned on the areas affected by gangrene and covered with gauze. These larvae feed on dead tissue, fortunately ignoring healthy ones. They also have a useful function in fighting infections, because they release substances that kill bacteria.
Some research has found that this treatment may be more effective than surgical debridement. However, most people are too scared or reluctant to try this solution because it is considered "disgusting"
Step 3. Undergo hyperbaric oxygen therapy
This is an alternative procedure which consists in entering a special chamber in which the air is pressurized. Then a plastic cap is lowered over the patient's head or asked to wear a mask through which he can breathe pure oxygen. While it may seem like a rather disturbing method, it is actually an effective therapy that provides a high supply of oxygen to the blood and areas affected by gangrene, improving blood diffusion and circulation. Thanks to this therapy, the blood reaches the affected areas even in people who have poor blood circulation.
- With an adequate supply of oxygen to the affected areas, the risk of amputation is reduced. Studies have confirmed that this therapy is effective in treating gangrene of the feet associated with diabetes, thus decreasing the chances of amputation.
- Discuss thoroughly with your doctor to assess whether hyperbaric oxygen therapy is a good solution for your specific case.
Step 4. Restore blood circulation with surgery
For this purpose, the main surgical interventions are bypass and angioplasty. Studies have shown that both surgical procedures are equally effective in restoring proper blood flow and reducing the need for amputation. However, angioplasty requires less recovery time, while bypass appears to be more effective in the long term. Consult your doctor about both solutions to evaluate which one is best for you based on your medical history as well.
- Bypass surgery. This surgery involves redirecting the blood flow "bypassing" the obstruction. The surgeon connects one of the veins to a healthy part of the arteries using a grafting technique.
- Angioplasty. This procedure involves inserting a thin balloon into a very narrow or blocked artery. The balloon is inflated to widen and open the passage. In some cases, a metal tube, called a stent, is inserted into the artery instead to keep it open.
Step 5. Take medication to reduce blood clots
Your doctor may prescribe anticoagulants to reduce blockages and thus improve blood circulation. A popular drug is warfarin, which usually has to be taken orally (2 - 5 mg) once a day (always at the same time) in the form of a pill. Warfarin inhibits and interferes with vitamin K, slowing blood clotting. This way the blood thins, making circulation more efficient.
Keep in mind that these drugs increase the risk of bleeding, so you shouldn't take them if you have a bleeding disorder (such as haemophilia), cancer, kidney or liver problems, heart disease or high blood pressure, among other diseases. Always consult your doctor before taking any medicines that may affect your blood's ability to flow and clot as usual
Step 6. Treat any type of infection
Antibiotics are typically given when gangrene is caused by an infection or in cases where an infection is feared due to an open or difficult-to-heal wound. Doctors often prescribe this class of drugs for patients who have had surgery to remove dead tissue from gangrene to prevent the infection from spreading to the remaining tissue. The drugs most often prescribed in this case are:
- Penicillin G. This has been the drug of choice for a long time. Typically 10-24 million units are given per dose (usually every 6-8 hours) intravenously (through the veins) or intramuscularly (into the muscles). This antibiotic is a bacteriostatic agent, which inhibits or prevents bacterial reproduction and development. It is usually preferred to administer it as an injection when the infection is severe or in patients who have undergone surgery, as it is possible to dispense a massive dose of the drug that reaches the affected areas faster than the oral formulation.. Currently, it is preferred to prescribe a combination of penicillin and clindamycin, which is a protein inhibitor.
- Clindamycin. This drug treats and prevents infections thanks to its bactericidal properties, which kill bacteria by blocking their protein synthesis. Without these proteins, bacteria cannot survive. The typical dose is 300-600 mg taken orally every 6-8 hours or 1.2 g intravenously twice a day.
Step 7. Rehabilitation therapy begins
After an operation in the operating room, the patient typically undergoes a rehabilitation program for the surgical wound. This is a fundamental procedure to restore the correct functioning of the affected areas, be it the fingers or toes, arms or legs. Part of the therapy consists in performing isotonic exercises to maintain the functionality of the affected areas. These exercises aim to move the joints along with the muscles of the arms and legs. Isotonic exercises include:
- Quick walk or simple walk;
- Cycling;
- Dance;
- Jump rope.
Part 3 of 3: Read up on the disease
Step 1. Know the causes of dry gangrene
It can be the consequence of several factors, including:
- Diabetes. This disease hinders proper blood flow, especially in the lower extremities, and can prevent wounds from healing properly.
- Vascular problems. These conditions, such as peripheral arterial disease (PAD), can reduce blood flow in the body. PAD, for example, is manifested by a narrowing of the coronary arteries or those of the rest of the body, mainly due to atherosclerosis, as this disease hardens them along with other blood vessels.
- Vasculitis. The term vasculitis refers to a number of autoimmune diseases that inflame blood vessels, such as Raynaud's phenomenon. In this condition, the blood vessels, especially in the fingers and toes, have spasms (called vasospasms), which in turn cause vasoconstriction or narrowing of the blood vessels. This autoimmune disease can be induced by exposure to cold or emotional stress.
- Smoking addiction. This can cause blockages in the arteries and thus impair proper blood flow.
- External injuries. Burns, accidents, wounds and surgical cuts can damage some cells in the body and slow down the blood supply. If wounds are not treated properly and major blood vessels are damaged or compromised, blood cannot flow properly into surrounding tissues. This results in an inadequate supply of oxygen to some parts of the body resulting in necrosis of nearby tissues.
- Cold burn. Exposure to extreme or very cold temperatures can disrupt normal blood flow. When temperatures are freezing, freezing can occur in as little as 15 minutes. Cold injuries typically affect the fingers and toes. To avoid this, you should wear insulated gloves and shoes to retain heat and protect you from moisture.
- Infections. A bacterial infection that is not properly treated can take over diseased tissues, causing them to die and thus leading to gangrene. This is more common with wet gangrene.
Step 2. Learn about the different types of gangrene
It can be divided into several categories, including:
- Dry gangrene. This is characterized by dry, withered skin that takes on a color ranging from brown to blue / purplish to black. It usually develops slowly and the tissues eventually peel off. This type of gangrene can become wet if it becomes infected.
- Wet gangrene. Its main features are swelling, blistering and a moist appearance of diseased tissues due to the leaking of secretions from the skin. This gangrene develops as a result of an infection and needs to be treated urgently, as it spreads quickly and can be very dangerous.
- Gas gangrene. It is a sub-type of the wet one. In this case the skin surface appears normal at first, but as the disease progresses it starts to turn pale, then gray, and finally takes on a reddish-purple color. Visible blisters may develop on the skin and crackles may also be heard when the affected area is pressed. This type of gangrene is due to an infection of the body caused by the bacterium Clostridium perfringens which produces the gas responsible for tissue death.
- Noma gangrene. It is a form of gangrene that develops rapidly and mainly affects the mouth and face. It occurs in particular on malnourished children who live in poor hygienic conditions.
- Internal gangrene. It occurs when blood flow to internal organs, such as the intestines, gallbladder, or appendix, is blocked. It often causes fever and a sharp, intense pain. If not treated promptly, it can be lethal.
- Fournier's gangrene. It is a rather rare form, as it affects the genital organs and the urinary tract. It is more common in men than in women.
- Meleney's gangrene or progressive bacterial synergistic. It is a rare form of gangrene that develops following surgery and is accompanied by painful skin lesions that occur a week or two after the operation. The pain is sharp and itchy.
Step 3. Know the symptoms of dry gangrene
This is a serious condition that requires immediate and effective medical attention. Anyone who has any of the symptoms listed below should see a doctor immediately to avoid any complications:
- Numbness, cooling of the affected area and a wrinkled appearance of the skin
- Lameness or cramps (for example in the legs when walking)
- Tingling sensation, stinging or itchy pain;
- Alteration of the color of the affected area (it can become red, pale, purple until it progressively assumes a black color, if it is not treated);
- Dryness of the painful area;
- Ache;
- Septic shock (hypotension, possible fever, confusion, dizziness, shortness of breath). This is an emergency that requires prompt intervention. It is a situation that rarely occurs in the case of dry gangrene, but it can occur if it is not treated properly.
Step 4. Seek immediate medical attention
Gangrene is not a disease that goes away on its own. If you don't treat her as soon as possible, you may need to have the diseased part of your body or a limb amputated. See your doctor right away to start recovering tissues as soon as possible.
- Keep in mind that some people experience no pain at all, so they don't seek medical attention until the area has turned completely black. Be very vigilant and notify your doctor right away as soon as you notice any signs. Don't wait for the situation to escalate.
- While home remedies are great and timely, they are probably insufficient to effectively treat dry gangrene. Start treating her as soon as possible and don't wait too long, so that the situation improves more quickly.
Warnings
- See your doctor as soon as you notice symptoms to get a prompt diagnosis and treat the condition as soon as possible.
- If you are at risk of developing dry gangrene, especially if you have diabetes or peripheral vascular disease, you need to take good care of yourself and pay attention to the symptoms. Visit your doctor regularly to keep informed of the risks and symptoms.
