Gangrene - causes, types (dry, wet, gas, etc.), first signs, symptoms and forms, diagnosis, treatment methods. Treatment of trophic ulcers in the onset stage

Mechanical injury skin on the leg can lead to the formation of wounds. Most often, they are not considered dangerous and can be treated at home. But even a small cut can get bacteria that can cause inflammation. This occurs due to lack of personal hygiene, decreased immunity, progression chronic diseases. If protective system the human body is weakened, there is a high probability of pus forming in the damage cavity. What is a purulent wound on the leg, and how to treat it?

A purulent wound on the leg means damage to an area of the skin into which bacteria have entered and infection has begun. Most often, inflammation becomes possible due to staphylococci and streptococci. Penetrating into the cut, they begin to form their own microflora, which is what causes suppuration. As a result, dead skin particles accumulate in the wound and bacteria actively multiply.

Purulent inflammations on the leg are characterized by the following symptoms:

There is swelling and redness of the skin around the wound.
The site of injury is painful and hot to the touch.
There is a throbbing pain inside the cut.
If treatment is not undertaken, intoxication of the body begins to develop. A person develops fever and weakness.

Leaving purulent wounds on the leg without treatment is very dangerous. This may entail serious consequences for human health, such as abscess, sepsis.

The most severe and unpleasant type of suppuration is a wound on the toes. Under the influence of bacteria, the finger swells, with back side A blister filled with pus appears at the site of the lesion. If the abscess continues to grow, it is advisable to consult a doctor for surgical help.

Purulent inflammations under the nail and on the toes require special approach in treatment. If medical attention is not promptly provided, there may be a risk of finger amputation.

How to treat such inflammation should only be determined by a specialist.

Causes of suppuration

The inflammatory process develops as a result of infection entering the damaged area. The risk of infection increases with summer period. This is especially true for a purulent wound on the leg.

There are several causes of infections:

lack of personal hygiene;
weakened human immunity;
work in unfavorable conditions, in dirt, dust;
poor nutrition, lack of vitamins;
disturbance of metabolic processes in the body.

Infection may occur after surgery. In this regard, they are never appointed elective surgeries for the summer period. If the operations are emergency, it is necessary to carefully treat the injury site.

There is a type of secondary purulent wounds on the leg. They refer to boils and abscesses. As a rule, the occurrence of such inflammation is directly affected by human health. Boils appear in people with reduced immunity and diabetes mellitus. Purulent wounds on the legs develop faster in older patients. Secondary purulent inflammations are treated only with surgery.

Treatment tactics

Treating a purulent wound on the leg at home is very dangerous. As a rule, after receiving an abrasion or scratch, people rarely go to the doctor. But even a small cut can cause major complications if not treated correctly.

How to cure a purulent wound on the leg? Treatment should combine a complex drug therapy and lifestyle changes. Much attention attention should be paid to the patient’s nutrition, since the development of suppuration can be provoked by a lack of essential nutrients in the body.

Treatment of a purulent wound on the leg should be carried out with the aim of:

Removing purulent masses from the wound.
Reduce swelling and relieve inflammation.
Fighting germs.

To treat purulent wounds on the legs, agents are most often used that improve the nutrition of damaged tissues, normalize blood circulation, and restore metabolic processes in organism. For this purpose, the following enzymes are used:

chymopsin;
chymotrypsin;
Terrilitin.

In severe cases, antibacterial drugs are prescribed. At the initial stage of inflammation, antibiotics are used wide range actions. After bacterial culture, medications can be replaced. They are prescribed in the form of tablets, ointments, and injections.

To treat wounds on the leg with a large accumulation of pus, bandages with Furacilin solution are used, and the affected area is washed with antiseptic agents.

If a tumor with pus on the leg does not open on its own for a long time, it is necessary to urgently contact a specialist. The surgeon will cut the pus, clean the wound and place a drain in the cavity, which will further facilitate the release of pus. In some cases, a swab soaked in antibiotics is inserted into the wound cavity. In addition, it is necessary to take a course of vitamins and take measures to improve immunity.

If your toe is festering, you can relieve inflammation with potassium permanganate baths. The solution should be weak, light pink in color. After the procedure, a bandage with ointment is applied to the treated finger. Your doctor will recommend how to treat wounds on your legs. Most often, Levomekol ointment is applied to the damaged area.

If the foot is affected by inflammation caused by fungi, antifungal drugs.

Treatment of purulent wounds at home

What to do if the wound has already been opened by a doctor and a bandage has been applied? You can treat leg wounds at home yourself. Daily disinfection is necessary for rapid healing and to prevent the spread of infection. Treatment of a limb with a purulent wound should be carried out 1–2 times a day. Please note that you can make dressings yourself only in mild cases of the disease.

To carry out the procedure, the following conditions must be met:

Mandatory disinfection of hands and tools. Most often this is done with alcohol.
The old bandage must be carefully removed; if it is strongly stuck to the wound, the bandage is moistened with hydrogen peroxide.
Remains of pus should be removed from the cavity, the edges should be treated with an antiseptic, sometimes they are lubricated with iodine or brilliant green.
The inside is processed medicine or place a napkin soaked in the drug. If the damage is very deep, a rubber drainage is inserted inside to remove pus.
The wound on the leg is covered with several layers of bandage and carefully secured. It is imperative to ensure that there is no air access to the affected area. This may lead to the development of an anaerobic infection.

If the injury is very severe, treatments must be done at least four times a day. In this case, you need to leave the wound in the air for 20 minutes during each treatment.

Folk remedies in the treatment of purulent wounds

Use in combination with traditional drugs, folk methods for the treatment of purulent wounds on the legs help fast healing. This is due to the fact that a number of bacteria have become insensitive to antibiotics over time. To carry out treatment with folk remedies at home, a number of requirements must be met:

You can treat yourself only simple suppurations on the leg, without signs of intoxication.
What to do and how should be recommended by the attending physician. The same applies to folk remedies.

Failure to comply with these conditions can cause harm and aggravate the situation.

Calendula tincture, aloe juice, plantain or burdock are often used to treat wounds on the leg. Tea tree or sea buckthorn oil can be used effectively.
Honey is used as a component for ointments.
Aqueous solutions of eucalyptus and calendula are used to wash the wound.
Purulent inflammation on the leg can be cured with onions boiled in milk. It is pushed aside and applied to the suppuration, then bandaged tightly. Every five hours it is necessary to change the bandages with gruel.
The rapid maturation of the purulent bladder contributes to Castor oil. It is preheated in a water bath, soaked in a cotton swab and tied to the site of suppuration.
The most widely used remedy is the use of aloe. The pulp is applied to the damaged area.

If suppuration occurs in a wound or cut on the leg, you should immediately consult a doctor. Timely treatment will prevent the development of complications.

Purulent wounds can appear at any age in any person. If incorrect or untimely treatment this leads to the most complex complications.

Therefore, it is extremely important to know what drugs and other means to use, how to carry out the procedures correctly.

If infection occurs when the integrity of the skin is damaged, then the issue of treating purulent wounds at home becomes acute. After all, suppuration leads to the most unpleasant consequences, up to gangrene.

Abscesses are a lumen with purulent fluid around which there is inflammatory process. The disease occurs against the background of infection of any wound (cut, scratch, puncture, etc.).

Simply put, pus is formed due to the penetration of a pathogenic microorganism into the wound.

A purulent formation can occur in any part of the body, but is most often found on the leg, arm, buttocks, abdomen, and fingers. Pus can have a thick or liquid consistency, as well as a different color.

It is the shade that allows you to determine the type of pathogen:

whitish and yellowish color a thick structure indicates infection with the staphylococcus bacterium;
with a liquid consistency of a brownish-yellow hue we're talking about about E. coli;
a watery structure of yellow and green color is characterized by infection with streptococcus;
brown, foul-smelling liquid – anaerobic microbes;
if the shade of pus inside is yellow, but changes color when in contact with air, then it is Pseudomonas aeruginosa.

Symptoms of purulent wounds

Bursting, throbbing or pressing pain.
Redness of the skin around the lesion.
On palpation, the skin feels hot.
Change in skin color at the site of pathology.
Swelling and headache.
Increased body temperature, chills, weakness.
Loss of appetite and increased sweating.

Causes of infection

As you know, purulent wounds occur due to infection. But why then does one person immediately notice the inflammatory process, while the other does not? It turns out that there are certain factors that influence the transformation of a simple wound into a purulent form.

First of all, this is a weakened immune system and the presence of certain pathologies (diabetes mellitus, HIV, etc.). They also play a huge role climatic conditions(high humidity), extensive pollution of the area.

A pathogenic microorganism can be introduced into a wound by dirty hands or using non-sterile processing materials.

The first question that arises is how to treat a purulent wound. Because the effectiveness and duration of subsequent therapy depends on this.

Not every person is ready to go to the clinic with such a minor problem. And it’s not always possible to see a doctor right away.

Therefore, it is necessary to know the rules of primary processing:

Wound disinfection and rinsing. What to wash with? Every home has hydrogen peroxide, so use this liquid. You can use Furacilin, potassium permanganate diluted in water, or a solution of Chlorhexidine.
Next you need to treat the area around the wound. To do this, you can take brilliant green or iodine. After this, you need to make a dressing (apply a sterile bandage).
Further care includes application of ointments, daily rinsing and other types of processing.
In particularly advanced cases, the doctor prescribes surgical intervention . For example, if the wound is lacerated, open, with the presence of foreign bodies, etc. The surgeon performs a deep cleaning, removing blood clots, fragments, dead tissue and cells. This will speed up the healing process. If necessary, the doctor excises the uneven edges and then applies sutures.

Quite often, the doctor suggests administering a special anti-tetanus serum, and for bites from unvaccinated animals, a rabies vaccine. You should not refuse the procedure, as this will prevent complications.

Basic processing algorithm purulent lesions consists in removing dead epithelium, cleansing purulent fluid, accelerating regeneration processes and preventing the development and growth of pathogenic microorganisms.

For processing, you will need a sterile bandage and gauze pads, scissors washed in alcohol, sterile gloves, adhesive tape, solutions and ointments.

Initially, the area around the wound is washed and treated with hydrogen peroxide, manganese or other solutions. Next, use scissors to cut a sterile napkin to the size of the wound, apply ointment to it and apply it to the lesion. After this, bandage it. All manipulations must be done with gloves.

If you remove a bandage with accumulated pus, do it with rubber gloves. After removing the purulent napkin, be sure to change your gloves. Otherwise, you risk spreading the infection throughout your body.

Treatment methods for purulent wounds

Before treating purulent wounds, you need to familiarize yourself with the basic methods. Medical principles of treatment include the following:

cleansing of purulent fluid and dead tissues and cells;
neutralization of swelling and other symptoms;
destruction of bacteria.

If the pus cannot be removed naturally, drainage is carried out. It can be passive or active.

In the first case, drainage from tubes, strips, turundas and napkins soaked in antiseptics is used. Active drainage involves the use of suction devices.

Since purulent wounds belong to the infectious group, the use of antibiotics is necessary. Depending on the severity of suppuration, various forms of drugs are used.

For example, with minor suppuration, local exposure is sufficient, and in more complex cases, complex treatment is prescribed. That is, the wounds are treated with antibacterial ointments and solutions, and the patient takes tablets orally. Injections are also prescribed quite often.

The most popular antibiotics for purulent wounds:

tetracyclines;
cephalosporins;
penicillins.

Modern pharmacology produces great amount universal ointments that have a comprehensive effect. But what ointment to use for purulent wounds in a particular case will be decided by the attending physician and directly by you.

List of the best ointments:

The most common and popular drugs:

Treatment at home: traditional medicine recipes

Modern medicine does not deny positive influence medicinal herbs and other components used in folk medicine.

After all, many drugs are made from plant extracts. That's why folk remedies are popular.

Juna is a folk healer, thanks to whom many people got rid of various pathologies. One of her recipes is unique ointment Junes.

Although, she personally claimed that this remedy came from the people, and she only recommended it. The ointment can draw out any purulent fluid in a short time.

So, you will need 1 yolk raw egg, 1 tsp. honey and 1 tbsp. l. wheat flour. Mix all ingredients thoroughly and store in the refrigerator.

If necessary, apply the resulting mixture directly to the hearth, covering the top with a piece of toilet paper or paper napkin. Be sure to apply a protective bandage.

The ointment can be changed every 3 hours throughout the day.. If you want to leave it overnight, feel free to leave it. After removal, you will find accumulations of pus that need to be removed. If there is no purulent liquid yet, then apply another layer of the mixture on top.

Almighty aloe flower

Aloe is a bactericidal plant that destroys pathogens, draws out pus and heals.

But how to use aloe correctly to achieve maximum effect? There are several ways:

Wash the plant leaf and cut it lengthwise. Apply to the affected area and secure. To enhance the antibacterial effect, you can drop a little iodine.
Peel the aloe and finely chop. Apply the paste to the wound.
Squeeze the juice out of the cleaned plant, soak a gauze cloth in it and apply it to the damaged area.

Aloe needs to be changed every 2-3 hours. Try to use a 3 year old plant. Be sure to treat the wound with any solution before the procedure.

Horseradish recipes

Horseradish is a powerful antibacterial plant, so it is used to treat purulent formations. Horseradish infusion is used as lotions, compresses and rinsing solutions.

Grind the root part, take 1 tbsp. l. and pour boiling water over it. It is advisable to insist in a thermos for 1 hour.

You can make a tincture from fresh leaves. Weigh 200 grams of the plant and twist the leaves through a meat grinder. You should get a slurry, which you need to fill with 1 liter boiled water(temperature slightly above room temperature).

Now place the mixture in glass jar and close the lid tightly. You need to insist for 12 hours. Do not forget to periodically stir the ingredients during this time.

Other recipes

Try not to self-medicate, this can lead to complications.. It is better to consult your doctor, as separate groups of drugs may be prescribed for each type of bacteria. And then you can easily get rid of the purulent wound!

Very often, patients with diabetes experience the development of various complications. One of the dangerous complications that manifests itself with the progression of diabetes is impaired blood circulation in the lower extremities, as well as disturbances in the conductivity of nerve fibers located in the tissues lower limbs.

Such disorders are externally manifested by appearing on the foot non-healing wounds and the leg begins to rot due to diabetes.

In such a situation, even if the soft tissue heals, the bone still continues to rot. This serious complication cannot be completely cured without compensation for diabetes mellitus.

The external manifestation of the disorder is the appearance of non-healing trophic ulcers on the surface of the skin of the foot. Emerging trophic ulcers lead to the development of sepsis in the body.

Sepsis is the body's response to the development of a local infectious process that develops in the area of trophic ulcer formation. Sepsis is caused by penetration of damaged skin extremities of purulent or putrefactive microflora. In some cases, sepsis may be caused by the development of a latent infection.

Sepsis is characterized by the constant spread of bacterial flora and its toxins throughout the body, which provokes the development of severe damage.

If skin damage is detected on the surface of the leg that does not heal for a long time, you should immediately seek help from the surgical department. medical hospital. The point is that treatment diabetic foot not performed in the diabetic department.

The development of trophic ulcers is caused by a complication of diabetes mellitus, which occurs as a result of damage to small vessels and nerve endings located in the tissues of the lower extremities.

Most often, the formation of trophic ulcers begins with the appearance of microtraumas on the skin of the toes that do not heal on their own.

Poor circulation in the tissues of the lower extremities leads to disturbances in cell nutrition. The appearance of trophic ulcers begins on the surface of the legs and gradually descends to the feet and heels, on which rotting tissue appears.

The treatment used to localize the disease and cure it is lengthy and complex.

Causes of trophic ulcers in diabetes mellitus

Diabetes of any type is an ailment that requires constant monitoring of sugar levels in the body. In addition, to prevent the development of complications, you should change your lifestyle and diet.

Changes in normal lifestyle are required in order to prevent the occurrence of disturbances in the functioning of the vascular and nervous systems that occur as diabetes mellitus progresses.

Disturbances in the nutrition of tissue cells of the extremities, in providing cells with oxygen and in the removal of toxic compounds formed in tissues occur more quickly if the body of a patient with diabetes mellitus has constant increased content glucose.

The development of trophic ulcers is observed when a person has an advanced form of diabetes mellitus. Most often, the development of ulcers on the surface of the skin of the lower extremities is observed when type 2 diabetes mellitus, which is non-insulin-dependent, progresses in the patient’s body.

Development of symptoms of ketoacidosis and presence high level sugar in the body occurs if the patient does not take his illness seriously and does not take actions aimed at relieving the consequences of the development of the disease.

To prevent the appearance of trophic ulcers, it is necessary for every patient suffering from diabetes not only to control the level of glycemia in the body, but also to carefully care for the skin of the legs, preventing the appearance of critical damage to the skin.

The fact is that even the slightest microtrauma can provoke the appearance of an ulcer.

Why do ulcers form? The cause of the appearance of trophic ulcers is the development in the patient’s body of complications such as diabetic angiopathy, which manifests itself in damage to small vessels of the circulatory system and diabetic neuropathy, which is damage to small nerve endings.

These disorders together lead to the formation of diabetic foot. This pathological condition lower extremities are prone to the formation of not only trophic ulcers, but also the development of gangrene. As a result of the development and spread of trophic ulcers over the surface of the lower extremities, adjacent tissues and blood become infected with toxins formed in the infectious focus, which is the trophic ulcer.

The development of trophic ulcers and gangrene of the lower extremities can be prevented by competent care of the extremities and strict control of sugar levels in the patient’s blood plasma.

Appearance of a trophic ulcer in diabetes mellitus

The occurrence of trophic ulcers is most often observed in the area nail phalanges toes. Sometimes trophic foci may appear on the surface of the heel.

The emergence of trophic foci is facilitated by the formation of corns and microtraumas during use. uncomfortable shoes or shoes that don't fit properly. There is also a high probability of occurrence trophic ulcer as a result of unsuccessful treatment, burns, abrasions and other traumatic effects on the skin of the lower extremities.

The result of such microtraumas is the formation of wounds that do not heal for a long time, which increase in size and depth over time. An increase in the area and depth of wounds facilitates easier penetration of purulent and putrefactive microflora into the wound surface.

As a result of the penetration of putrefactive and purulent microflora onto the wound surface, tissue becomes infected and the process of tissue decay begins, which significantly complicates the process of treating complications.

The features and differences of trophic ulcers in the presence of diabetes mellitus are the following:

In the presence of small-sized ulcerative surfaces, the patient experiences the appearance of clearly defined pain, which intensifies at night. In some cases, with severe diabetic polyneuropathy, pain may be absent, even in the case of large and deep wounds.
Self-healing of trophic ulcers during development in the body diabetic angiopathy and polyneuropathy does not occur.
Trophic foci in diabetes mellitus can increase in area and deepen. These lesions can lead to the development of gangrene in the patient, which will require surgical intervention consisting of amputation of the damaged part of the limb.

The appearance of trophic ulcers is possible both with the latent development of diabetes mellitus and if the patient has varicose veins.

This situation requires additional examination the patient’s body to determine the causes of trophic foci and prescribe appropriate adequate treatment.

Stages of development of trophic ulcers in diabetes mellitus

There are several stages of development of trophic foci when a patient has diabetes mellitus.

The first stage is the stage of the emergence of a trophic focus. At this stage, the trophic ulcer gradually increases in size and deepens. The bottom of the ulcer is covered with a white coating. In some cases, the plaque may be a dirty gray or gray color.

At this stage of wound development, an unpleasant odor appears, and a person may feel numbness and coldness of the feet, which is associated with impaired blood circulation and tissue innervation.

The second stage is characterized by cleansing of the trophic ulcer. At this stage, the ulcer is cleared of plaque, and the bottom of the wound becomes bright pink. At this stage, the size and depth of the ulcer do not change.

Thank you

Gangrene- this is the death of body tissues that have a connection with the environment, while the organ acquires a dark, black color. The disease is characterized by a severe course, threatens organ loss and is life-threatening for the patient.

Gangrene was very a common occurrence before the invention of antibiotics and various methods instrumental and laboratory diagnostics, especially during wars. Most limb injuries resulted in their loss. Gangrene also often developed in a hospital setting, as a postoperative complication and the result of a nosocomial infection.

Nowadays, when a huge number of antibiotics are available, this disease is also not uncommon. Thus, according to statistics, more than half of patients with insulin-dependent diabetes mellitus develop gangrene of the lower extremities within 20 years.

Interesting Facts!

Causes of gangrene development

There can actually be many reasons for the development of gangrene. But it all comes down to one thing - the lack of blood supply in the affected organ, as a result, oxygen does not enter the tissue, and without oxygen, necrosis, or tissue death.

Circulatory disorders (“ischemic gangrene”) most often develop in older people:

Diabetes mellitus is the most common reason gangrene, most often affecting the lower extremities, namely the feet.
Atherosclerosis – in the obliterating form of the disease, an atherosclerotic plaque can completely block the lumen of blood vessels, preventing the flow of blood to the organ.
Obliterating endarteritis is an autoimmune vascular lesion that often develops in heavy smokers.
Blockage of blood vessels by a blood clot, and the blood clot can break off after surgery, bleeding, or childbirth.
Thrombophlebitis of the lower extremities.
Raynaud's disease is a syndrome of many diseases in which the innervation of blood vessels is disrupted (systemic lupus erythematosus, scleroderma, severe course cervical osteochondrosis).
Myocardial infarction, ischemic stroke, pulmonary infarction and other diseases.

Impact of physical factors:

Frostbite of the extremities;
burns;
electric shock, including lightning.

Mechanical tissue damage:

Injuries and wounds in which the integrity of blood vessels and nerves is disrupted - gunshot wound, injury from shell fragments, road accidents, and so on;
bedsores of bedridden patients;
state after an “unsuccessful” operation;
prolonged compression of an organ - being under rubble, in a car after an accident, prolonged application of a hemostatic tourniquet or tight plaster bandage, wearing narrow rings, shoes, pulling unusual objects onto the penis, strangulation of a hernia, and so on.

Infectious pathogens of gangrene:

Anaerobic gas gangrene - the causative agent is anaerobic bacteria clostridia;
Purulent diseases caused by staphylococci and streptococci: lung abscess, purulent appendicitis, peritonitis, etc.;
protea;
meningococcal infection (meningococcemia);
tuberculosis (with caseous pneumonia, pleural empyema);
leprosy or leprosy, and others.

Infections can cause gangrene with or without other factors that impair blood circulation (diabetes, wounds, burns, severe intoxication, etc.). In the presence of diabetes mellitus, even slight paresis and wearing tight shoes can lead to tissue necrosis.

Dry gangrene is the result of a long-term circulatory disorder under aseptic (without infection) conditions. This type of gangrene leads to mummification of the affected area, which over time can become detached from the body (amputated). Dry gangrene mainly affects the extremities. Often both limbs are affected, symmetrically. In most cases, dry gangrene does not threaten the patient’s life until infection occurs.

Wet gangrene is always a threat to the patient’s life, since infection is involved in the process. This type of gangrene occurs in the extremities, genitals, lungs, intestines and other internal organs.

Types of gangrene depending on the cause of development

Ischemic gangrene;
infectious gangrene;
anaerobic gas gangrene;
toxic gangrene;
allergic gangrene;
hospital gangrene (developing in a hospital, for example, after surgery).

ICD-10

The ICD is a classification generally accepted throughout the world that allows you to encrypt the diagnosis. This is necessary for statistical calculations, documentation, concealment of the diagnosis at the request of the patient and understanding of the diagnosis by foreign doctors.

Gas gangrene – A 48.0;
Gangrene associated with atherosclerosis – I 17.2;
Gangrene in diabetes mellitus – E 10.5 – E 14.5;
Dry or wet gangrene of the extremities – R 02;
Intestinal gangrene – K 55.0;
Lung gangrene – J 85.0;
Tooth gangrene – K 04.1;
Gangrene in Raynaud's disease – I 73.0.

How does gangrene develop? (pathogenesis)

Stages of development of dry gangrene
1. Long-term circulatory disorders (vascular diseases, ischemia) - cells do not fully receive the necessary oxygen, fluid and nutrients, accumulates metabolic products.
2. Tissue necrosis or tissue death in an area where blood does not reach.
3. Defensive reaction immune system, wherein immune cells limit dead tissue from healthy tissue, a clear inflammatory ridge is formed.
4. Mummification stage. There is a loss of fluid and drying out of dead tissue, the organ decreases in size and becomes black. Due to the small amount of liquid and the absence of pathogenic bacteria in the affected area, the processes of decay are inhibited, so no a large number of toxins, which is not dangerous for the patient.
5. Progressive gangrene occurs over time, the body rejects dead tissue - amputation occurs.
6. When infection occurs at any stage, putrefactive processes, that is, wet gangrene, may develop.

Stages of development of wet gangrene
1. Acute termination blood supply to the organ (trauma, blood clot, frostbite, etc.).
2. Fast development tissue necrosis, sometimes lightning fast, for several hours.
3. Attachment of infection, development of an infectious inflammatory process.
4. Rapid decomposition of dead tissue (rotting): swelling, pain, darkening, increase in volume of the affected area.
5. Immune reaction - immunity cannot limit necrosis from healthy areas, infection spreads and large amounts of toxins enter the blood.
6. Toxins from bacteria and destroyed tissues, entering the blood, worsen the general condition and lead to disruption of the functioning of all organs and systems of the body. At this stage, in addition to toxins, bacteria can also enter the bloodstream - sepsis (blood poisoning) develops. Sometimes only a few hours pass before the development of multiple organ failure (failure of vital internal organs), which threatens the patient’s life.

Why does gangrene cause black skin?
Firstly, blood does not flow to the affected area, and it is this that gives the pink color to our skin. Secondly, decay products accumulate in the tissues, including hemoglobin (a blood protein that carries oxygen and carbon dioxide). The iron contained in it binds with sulfur, which is released from the destroyed tissue of the skin, muscles, and nails. Iron sulfide salt has a black metallic color in the absence of oxygen.

Symptoms and signs, photos

First signs. How does gangrene begin?

The heat exchange of the skin is disrupted, it becomes cold to the touch;
the sensitivity of the skin is impaired, a feeling of numbness appears in the affected area;
weakness and fatigue appear;
movements and their coordination are impaired; if it concerns the lower extremities, lameness appears; If upper limbs, then everything falls out of hand;
pain and burning appear in the affected areas.

Dry and wet gangrene initially have common symptoms, the only difference is in the timing of their development. Dry gangrene begins gradually, slowly, sometimes over months and years, and the development of wet gangrene occurs over hours or several days. Further treatment depends on the type of gangrene - dry or wet.

Photo: signs of circulatory disorders in the fingers, Raynaud's syndrome.

Symptoms of dry gangrene of the extremities

With the development of dry gangrene, the fingers, hands or feet first acquire a bright red color or, conversely, they become cyanotic;
then the skin becomes pale, an unhealthy shine, marbling appears, the skin gradually darkens, acquiring a bluish tint, and then completely blackens;
all skin changes with dry gangrene develop from peripheral parts to the center, to the point of cessation of blood circulation;
a clear boundary is visible between the area of gangrene and the healthy area - the contrast between black and pink skin, the compaction is also determined - a demarcation roller or a demarcation shaft;
the affected limb decreases in size and becomes deformed;
unlike wet gangrene, there is no putrid smell;
the pain stops and any sensitivity in the affected limb disappears;
there is also no pulse;
with trauma and infection of the affected limbs, dry gangrene can become wet, but in most cases this occurs on initial stages diseases when the affected limb is not yet completely dry.

Photo: dry gangrene of fingers right hand– the result of circulatory disorders after a stroke. Distal phalanges the fingers are reduced in size, dry, black in color, they have mummified, there is a clear boundary between gangrene and healthy tissue.

Symptoms of wet gangrene of the extremities

The skin becomes pale and appears vascular network from dilated veins;
swelling of the affected area appears, due to which it increases in size;
there are no boundaries between the gangrenous and healthy areas, gangrene can spread to other areas;
brown blisters form (due to filling with blood), which quickly open, and in their place wounds form - trophic ulcers, which have a dirty gray color;
when pressing on the bubbles, a characteristic crunch is heard - this is an accumulation of hydrogen sulfide - a product of the breakdown of soft tissues and muscles;
fetid rot is released from the ulcer;
all these manifestations are accompanied by a violation general condition, which is associated with intoxication by bacterial decay products and necrosis of one’s own tissues.

Photo: wet gangrene of the right foot with “diabetic foot”. An atrophic ulcer with a dirty color is detected, there is cyanosis around it, the skin of the foot is glossy and turns black.

Features of pain with gangrene

For dry gangrene The pain is tolerable at first, then its intensity intensifies, becoming strong, acute, and debilitating. They do not stop after taking conventional painkillers; they often require strong and even narcotic drugs, which also may not alleviate the torment. The pain is especially worse at night. The patient often takes a forced position, grasping and pinching the affected areas. The condition is alleviated by raising or lowering the limb; for some, it becomes easier while walking.

The pain stops only after complete necrosis of the limb, that is, after it has completely blackened. In some patients, after complete death of a limb, phantom pain may appear - pain in a limb that does not exist (after amputation), scientists still cannot explain this phenomenon. Phantom pain is almost impossible to stop.

For wet gangrene the pain appears suddenly, it is acute and also does not stop after taking strong analgesics. There is an opinion that after the onset of pain due to circulatory problems, the patient and the doctor have only a few hours to prevent the organ from dying. With the appearance of ulcers and rotting of a limb or organ, the pain in most cases does not stop, which is associated with the spread of rotting to other areas.

Temperature and intoxication

With dry gangrene, there are usually no symptoms of intoxication, the general condition of the patient is good or slightly impaired, weakness and fatigue are possible.

But with wet gangrene, intoxication gains momentum, the patient’s general condition deteriorates sharply and is serious. IN in rare cases wet gangrene occurs without pronounced symptoms of intoxication, but this does not indicate mild flow gangrene and a good prognosis.
Symptoms of intoxication in a patient with wet gangrene:

increase in body temperature to high numbers, sometimes up to 40-41 o C;
severe chills, tremors of extremities;
rapid heartbeat, more than 90 per minute;
blood pressure drop below 90/60 mm Hg. Art.;
severe weakness, the patient cannot get out of bed;
possible confusion, delirium, convulsions;
with severe intoxication and the development of sepsis, other organs are also affected: the brain, kidneys, liver, heart, lungs, blood vessels, a blood clotting disorder occurs - bruises and hemorrhages appear, the patient may die from multiple organ failure (failure of vital organs).

Features of the course of some forms of gangrene

Anaerobic gas gangrene

The causative agent of gas gangrene is Clostridium bacteria.

The genus Clostridia includes the causative agents of botulism and tetanus. All these bacteria secrete strong poisons - toxins.

Microbiology of clostridia

Kingdom	Bacteria
Type	Firmicutes
Class	Clostridia
Genus	Clostridia
Kinds, causing gangrene	Clostridiumperfingens – causes almost all cases of gas gangrene, Clostridium septicum Clostridium histolyticum, Clostridium oedematiens
Bacteria shape	spindle sticks
Dimensions	Length – 2 – 10 microns, width – 0.5 – 1.5 microns.
Gram stain	Gram-positive bacteria
Growth on nutrient media – sowing to obtain a bacterial culture.	Milk + glucose + blood agar, temperature 37 o C. The beginning of growth is 18-20 hours, obtaining a culture is 5 days.
Conditions for reproduction	Lack of oxygen, that is, these are anaerobic bacteria. In the process of life they produce a large amount of gases, *hence the name – gas gangrene.*
Source of infection	Human and animal feces.
Who is affected?	People; rabbits, guinea pigs; large and small livestock; other mammals.
Prevalence and persistence in environment	Bacterial spores persist in the soil and can live there for many years. Clostridia themselves are unstable in the environment and die.
Gate of infection	Extensive, deep, contaminated wounds, as well as when foreign objects enter the wound.
Toxins	Produces a large number of toxins, at least 13. All these substances are very dangerous poisons, when they are introduced into the blood of laboratory animals, rapid death is observed.

Features of the course of gas gangrene:

it is always wet gangrene;
the presence of large bubbles containing blood and gases formed during the life of clostridia;
when pressing on the skin, a special crunch is heard;
always severe intoxication;
very fast and progressive course.

Photo: gas gangrene of the left leg. The limb is dark in color, swollen, there are large blisters with brown contents and ulcers on the foot.

Forms of gas gangrene:
1. Emphysematous form – characterized advanced education gas-containing bubbles, sometimes their size reaches more than 10 cm in diameter.
2. Edema-toxic form – swelling of the affected organ and intoxication predominate, blisters are small and isolated.
3. Mixed form – this is a combination of clostridia with a coccal infection (staphylococci, streptococci). This form is especially severe, characterized by rapid putrefactive processes and the spread of infection over large areas.

Fournier's gangrene

Fournier's gangrene is necrosis of the scrotal tissue; usually this form of gangrene occurs violently, lightning fast, and always threatens the patient's life.

Necrosis of the scrotum occurs as wet gangrene due to infection of the tissues by various bacteria. Typically, gangrene occurs after injury to the external genitalia.

Symptoms fulminant gangrene scrotum:

pain, redness, swelling in the scrotum area;
increased pain syndrome;
the skin of the scrotum becomes black;
ulcers appear with purulent discharge;
severe intoxication.

The prognosis for Fournier's gangrene is unfavorable. In half of the cases, patients die without timely treatment.

Intestinal gangrene

Intestinal gangrene is also, in most cases, the result of circulatory disorders in the intestinal vessels (ischemia, thrombus, wounds and trauma). Gangrene can also occur during an infectious process, for example, with peritonitis, intestinal obstruction, purulent appendicitis, mesenteric tuberculosis lymph nodes and so on.

Symptoms of intestinal gangrene:

sudden onset;
sharp, unbearable pain in the abdomen;
weakness;
blood pressure drops below 90/60 mm Hg. Art.;
increased heart rate above 90 per minute;
thready pulse;
possible disturbance of consciousness, up to its loss;
vomit;
diarrhea or constipation; stool may contain blood;
when listening to intestinal peristalsis (motility), you can hear pulsation in the abdominal area;
after 2 hours, symptoms of intoxication intensify.

When intestinal necrosis occurs in urgently surgery is necessary, this threatens the patient's life. A favorable prognosis is possible if surgical treatment is performed within 2 hours from the onset of the first symptoms.

Photo: This is what intestinal necrosis looks like due to thrombosis of mesenteric vessels.

Gangrenous cholecystitis

Gangrenous cholecystitis is necrosis of the gallbladder. The main cause of such gangrene is gallstones.

Symptoms of gangrenous cholecystitis:

usually acute onset;
severe abdominal pain, which can radiate to the chest, under the shoulder blade, to the lumbar region, to the right shoulder, the pain intensifies when lying on the right side;
pronounced symptoms of intoxication: temperature above 39-40 o C, severe weakness, headache and so on;
nausea and vomiting not associated with food intake;
bloating;
On examination, sharp pain is observed in the area of the right hypochondrium.

Necrosis of the gallbladder must be differentiated from myocardial infarction, peritonitis, acute appendicitis, and even renal colic.

Gangrenous cholecystitis also requires urgent surgery and threatens the development of purulent peritonitis and sepsis.

Gangrenous appendicitis

Gangrenous appendicitis is partial necrosis vermiform appendix(appendix). The main reason for such necrosis is acute appendicitis, which was not promptly recognized and operated on. In rare cases, the cause of gangrenous appendicitis is atherosclerosis.

Symptoms of gangrenous appendicitis:

Typically, gangrene of the appendix occurs 2-3 days after the onset of symptoms acute appendicitis;
pain in left iliac region, which are characteristic of acute appendicitis, subside;
begins severe vomiting, which exhausts the patient; blood may be present in the vomit;
symptoms of intoxication are expressed (serious condition of the patient, increased heart rate, decreased blood pressure), but the body temperature is normal, this is a characteristic syndrome for gangrenous appendicitis - “toxic scissors syndrome”.

If the cause of gangrene of the appendix is a circulatory disorder, then it comes to the fore pain syndrome and intoxication, while the body temperature will be high (above 39-40 o C).

Gangrenous appendicitis requires urgent removal of the appendix, as it threatens the development of peritonitis, sepsis, and intestinal gangrene.

Photo: removed appendix for gangrenous appendicitis.

Abscess and gangrene of the lung

Gangrene of the lung is very serious disease which may result in the death of the patient from sepsis, shock, pulmonary hemorrhage, respiratory and heart failure.

Causes lung gangrene:

pulmonary embolism (PE) – blockage of pulmonary vessels by a blood clot;
lung abscess - a purulent disease, a complication of bacterial pneumonia;
penetrating gunshot or knife wounds into the chest cavity, fracture of ribs with displacement of fragments;
foreign bodies in the bronchi, including aspiration of vomit;
purulent pleurisy;
sepsis – infection through the blood or septic pneumonia;
pulmonary tuberculosis: caseous pneumonia, fibrous-cavernous tuberculosis, pleural empyema.

Photo: pathological material, lung gangrene.

Symptoms of lung gangrene:

the development of gangrene of the entire lung is possible, since necrosis very quickly spreads to healthy tissue, but there are cases of bilateral total gangrene, this condition is incompatible with the life of the patient;
sharp sharp pains on one side of the chest, worsening with deep breathing and any movement, coughing, sneezing and even talking;
severe shortness of breath - difficulty inhaling and exhaling;
intense symptoms of intoxication, the patient’s condition is severe and extremely serious;
a painful cough with dirty, dark-colored sputum that has a foul, putrid odor;
possible hemoptysis or pulmonary hemorrhage;
the skin becomes sharply pale, bluishness of the skin of the face and limbs is observed;
symptoms of heart failure appear (low blood pressure, increased heart rate, swelling, and so on);
possible development of infectious toxic shock(drop in blood pressure, lack of urine, rashes and bruises).

Diagnostics

Typically used to diagnose gangrene of the extremities an experienced doctor It is enough just to examine the patient. But still, to diagnose the type of gangrene, the reasons for its development, assess the general condition of the patient, the presence of complications and to determine the treatment method, additional types of research are required. It is more difficult to determine gangrene of internal organs, without laboratory and instrumental methods is not necessary, and sometimes a biopsy of the affected organ is required.

Laboratory research methods for gangrene

Research method	Type of gangrene	Pathological changes
General blood analysis	Dry gangrene	In most cases, there are no pathological changes; the ESR may be slightly accelerated. With atherosclerosis and thrombosis - an increase in the number of platelets (more than 320 G/l)
General blood analysis	Wet gangrene	Significant increase in leukocytes (more than 9 G/l); acceleration of ESR (more than 20 mm/h); increase in the level of band neutrophils (more than 5%); possible appearance of basophils (1-2%); decrease in the number of lymphocytes (less than 27%); increased platelet level (more than 320 G/l).
Blood chemistry	All types of gangrene	*Increased blood sugar levels* with diabetes mellitus (more than 5.5 mmol/l); *promotion* cholesterol in atherosclerosis (above 8 mmol/l); *significant increase in AST levels* (aspartate aminotransferase) – several times (especially in the initial stages of gangrene); *decrease in level* albumin (less than 20 g/l) and *increase in globulin levels* (over 36 g/l); *increased fibrinogen levels* (above 4 g/l); *high levels of C-reactive protein, sialic acids, seromucoid* characteristic of wet gangrene.
Blood for sterility	Wet gangrene	Bacteria in the blood are detected when sepsis or blood poisoning develops. Be sure to determine the type of pathogen and its sensitivity to antibiotics.
Bacteriological culture of wound contents	Wet gangrene	They take a scraping from the ulcer, then sow it on nutrient media, isolate the pathogen and determine its sensitivity to antibiotics, this is necessary for correct selection treatment.
Sputum analysis: microscopy; bacterial culture.	Lung gangrene	Increased level of white blood cells; the presence of red blood cells and “dead” tissue in the sputum; identifying bacteria, including tuberculosis, it is necessary to find out sensitivity to antibiotics.

Instrumental research methods for gangrene

Type of study	Form of gangrene	Description of possible changes
Radiography	*Gas gangrene of the extremities* Photo: gas gangrene of the left foot.	X-rays of the extremities with gas gangrene show multiple gas bubbles different sizes. Conventional radiographs provide sufficient information. But if bone damage is suspected and to determine the level of necrosis of the limb, computed tomography (CT) will be more informative, especially in preparation for surgery.
Radiography	*Lung gangrene* Photo: plain radiograph organs chest cavity with gangrene of the right lung.	On radiographs of the chest organs, an area of darkening is visible, which occupies 1-2 lobes or the entire lung, the affected lung is reduced in size, areas of clearing are noted - necrosis cavities, and levels of pus in them are often visible.
Bronchoscopy	*Lung gangrene* Photo: bronchoscopy for gangrene of the lungs.	When examining the bronchi using a bronchoscope, the bronchus and pus are blocked by “dead” tissue. This is the main criterion for diagnosing pulmonary gangrene.
Ultrasound of the chest cavity	*Lung gangrene*	Ultrasound for pulmonary gangrene is used to determine the dynamics during treatment in order to minimize radiation exposure. This method allows you to assess the presence of cavities of decay of lung tissue, the level of pus in them, as well as the presence of pus or other fluids in pleural cavity.
Angiography – examination of blood vessels by introducing a special catheter and a contrast agent into them, the result is scanned using fluoroscopy (the image is displayed on the screen).	Photo: CT arteriography for pulmonary embolism.	In case of gangrene, angiography reveals areas of vessels that are narrowed or blocked by a thrombus. This study is necessary to determine the causes of the development of gangrene and the tactics of future treatment. This study requires hospitalization of the patient, there are risks associated with the effects of contrast and radiation exposure. With a CT scan, the radiation dose is greater than with conventional radiography.
CT arteriography – This is a type of angiography in which the result is assessed using computed tomography.	Photo: CT arteriography for pulmonary embolism.
Doppler ultrasound or duplex ultrasound scanning of blood vessels– examination of blood vessels using ultrasound.	*Gangrene associated with poor circulation*	Ultrasound also allows you to assess the patency of blood vessels and the volume of blood flow through them. More safe method than angiography, since it is performed without x-rays and the introduction of a contrast agent. On ultrasound, you can examine the lumen of the vessel, its inner wall and even an atherosclerotic plaque that blocked the vessel. But this method is inferior in visualization to angiography.
Diagnostic laparoscopy and thoracoscopy with biopsy of the affected organ	*Gangrene of internal organs* (lungs, intestines, gall bladder, appendix, heart and so on). Photo: laparoscopy for gangrenous appendicitis.	This is an invasive (penetrating into the body, traumatic procedure) method. To do this, punctures are made in the chest or abdominal cavity, insert an endoscope there and look on the screen to see what is happening to the internal organ, whether there is necrosis there. Using special instruments, the surgeon takes a biopsy of the affected areas. The resulting biopsy is examined by pathologists who make a conclusion about the diagnosis and possible reason development of the disease. If necessary, diagnostic laparoscopy can become therapeutic, that is, it is possible to remove dead tissue or restore vessel patency (stenting, bypass).

Complications and consequences of gangrene

Gangrene is a severe pathology that usually does not go away without a trace and has big risk development of complications, life-threatening patient.

Spread of gangrene over large areas
If wet gangrene is not treated in a timely manner, necrosis quickly spreads to healthy tissue. So, if the foot is affected, after a few days gangrene may develop up to the level of the knee. This increases the risk of developing other, more severe complications, including sepsis.

Sepsis, or blood poisoning
Sepsis can occur with wet gangrene, when bacteria and their toxins enter the bloodstream en masse and spread throughout the body. This condition is life-threatening; the patient may die from toxic shock, cerebral edema, or septic endocarditis (heart damage).

The main signs of developing sepsis:

high fever;
drop in blood pressure;
the appearance of rashes throughout the body in the form of bruises;
convulsions;
violation heart rate and breathing;
confusion or loss of consciousness and other symptoms.

With the development of sepsis, powerful antibiotic therapy and detoxification are necessary, and the issue of removing organs affected by necrosis is also resolved.

Limb amputation
With dry gangrene, the limb dries out (mummifies) and over time may “fall off” on its own. But more often surgical amputation occurs, which is carried out in order to save the patient’s life.

Transition from dry gangrene to wet gangrene
Dry gangrene, especially at the onset of the disease, can be complicated by the addition of bacterial flora. This is manifested by the presence of intoxication and the spread of gangrene to overlying tissues, that is, the boundary between dead and healthy tissues ceases to be defined.

Peritonitis and intestinal obstruction
This complication often develops with gangrene of the intestine, appendix and gallbladder. In this case, the infection from the affected organs spreads to serosa abdominal cavity. Without surgical treatment, this condition can lead to the death of the patient.

Treatment

Gangrene is always an indication for hospitalization in the surgical department of a hospital. Treatment of gangrene must be started urgently.

cure this state quite difficult. Treatment is always comprehensive, aimed at preserving the patient’s life, the cause of the development of gangrene, restoring blood circulation and preventing the spread of the process.

The amount of treatment directly depends on the type of gangrene.

Treatment of dry gangrene

1. Anesthesia, novocaine blockades.
2. Drugs that improve blood circulation: Actovegin, Neuroxone, Piracetam, Cinnarizine, Nicotinic acid, Pentoxifylline (Trental), Vazaprostan, Reopoliglyukin, Perftoran and other infusion solutions.
3. Drugs that destroy blood clots: Streptokinase, Actilyse, Retavase, Levostor, Aspirin, Heparin, etc.
4. Oxygen inhalation.
5. Surgery:

intravascular (endovascular) operations;
bypass surgery and stenting of blocked vessels;
amputation of dead tissue - affected limbs are routinely removed above the demarcation line from healthy tissue.

Treatment of wet gangrene

1. Antibacterial therapy.
2. Surgical treatment – removal of all “dead tissue”, amputation if necessary.
3. Detoxification therapy: intravenous infusion of various solutions.
4. Diuretics.
5. Treatment concomitant diseases: insulin therapy for diabetes, drugs that improve blood circulation, hormones, and so on.

Treatment of gas gangrene

1. Surgical treatment - removal of affected tissue or amputation, local debridement wounds, wound access to fresh air(bandaging the wound is not recommended).
2. Hyperbaric oxygen therapy - placing the injured limb in a pressure chamber under high pressure oxygen. Oxygen is detrimental to clostridia, the causative agent of gas gangrene.
3. Antibiotics.
4. Antigangrenous serum is a drug containing antibodies to the main types of clostridia.

Treatment of gangrene of the lung, intestines, gangrenous cholecystitis and appendicitis

Treatment of lung gangrene:

Antibiotics intravenously and intramuscularly.
Introduction of antibiotics and antiseptics into the bronchi using a bronchoscope.
Detoxification therapy – intravenous drip administration solutions.
Drugs that dilate the bronchi: inhalations of Salbutamol, Ventolin, Berodual, injections of Eufillin.
Drugs that enhance immunity.
Surgical treatment: removal of part or amputation of the entire lung when a lung abscess (ulcer) forms, freeing the pleural cavity from pus. Surgical treatment is resorted to only if there is no effect from drug therapy.

Treatment of intestinal gangrene:

urgent surgery removal of the affected area of the intestine;
antibiotics.

Treatment of gangrenous cholecystitis and appendicitis:

surgical removal of the affected organ;
antibiotics.

Use of antibiotics

Indications for antibiotic therapy are any wet gangrene.

Considering that with tissue necrosis there is usually not just one type of bacteria, but a whole spectrum, antibiotics must act on all possible microorganisms, so not one antibiotic, but two or even more are often prescribed. The drugs are administered in the form of intravenous or intramuscular injections, and maximum doses are used. Recently, the method of administering antibiotics inside the lymphatic plexuses and vessels has proven itself to be successful.

The most commonly used antibacterial medications to treat gangrene are:

Use of painkillers
Painkillers are used for any type of gangrene, as patients are concerned about unbearable pain. But, unfortunately, even narcotic drugs are not able to alleviate the patient’s suffering, as surgeons joke: “The best pain reliever is amputation.”
Types of pain relief for gangrene:
1. Narcotic drugs(Morphine, Tramadol, Omnopon) – a good short-term effect, but their use can develop drug addiction, especially with long-term use.
2. Non-narcotic painkillers (Analgin, Ibuprofen, Dexalgin) have a very weak and short-term effect.
3. Novocaine blockades - the affected areas are injected with novocaine. This method not only reduces the intensity of pain, but also dilates blood vessels, improving their patency.
4. Epidural anesthesia is the injection of anesthetics into the spinal canal. Suitable for gangrene of the lower extremities and scrotum.
5. Physiotherapy – neurostimulation of the spinal nerves.
Ointments for gangrene
In traditional medicine, ointments are rarely used to treat gangrene, since they may not only not help, but also cause harm.
Among those used, ointments containing antibiotics or antiseptics can be distinguished. These are Vishnevsky ointment, Levomekol, Iruksol, Solcoseryl. But these ointments cannot be used alone; they can help in combination with other treatment methods.
Surgical operations for gangrene, main types
1. Endovascular (intravascular) operations: aimed at restoring the patency of a blood vessel:
- Thrombolysis is the removal of a blood clot blocking a vessel.
- Stenting is the installation of a special device - a stent - into the lumen of a narrowed vessel, which becomes a kind of frame for it, through which blood circulates unhindered.
- Bypass surgery is the creation of an artificial vessel through which blood can circulate to bypass the blocked vessel.
- Vascular prosthetics is the replacement of a non-functioning vessel with an artificial prosthesis or a transplanted vessel.
2. Necrectomy– excision and removal of “dead” tissue, can only be used for shallow necrosis of the skin and soft tissues. This operation allows you to save the limb, but increases the risk of complications.

3. Amputation of a limb– removal of the limb above the affected areas followed by the formation of a stump. Amputation is necessary in case of rapidly progressing gangrene, lack of effect from other treatment methods, and is carried out for health reasons. After complete formation of the stump, limb prosthetics is possible.
Is it possible to cure limb gangrene without amputation?
Half of patients with gangrene undergo amputation of the affected organ. Amputation is not a whim of a surgeon, but an event aimed at saving a life; this is the last thing a doctor resorts to when nothing else helps. It can be avoided with timely consultation with a doctor, a good response to drug treatment, and the elimination of factors that worsen blood circulation in the affected organ.
How to cure gangrene at home? Traditional methods of treatment
Gangrene is not treated at home, as this disease threatens the patient’s life. Every hour counts, the more time of inactivity, the higher the level of amputation. There is no time to experiment with herbs and other traditional medicine.
Traditional medicine will come to the rescue in combination with other traditional methods treatment, but these must be means that increase protective forces body, containing useful substances, vitamins and microelements.
Gangrene of the leg (diabetic foot): surgical treatment without amputation - video

Forecast
Prognosis for dry gangrene relatively favorable, since such necrosis does not threaten the patient’s life. Although, if we consider the ability to work, then, of course, dry gangrene leads to the loss of a limb and disability. In addition, dry gangrene can develop over time on the second limb, in a symmetrical area.
For wet gangrene half of the patients are left without a limb, and amputation is performed significantly above the affected segment. There is also a very high risk of developing sepsis and death of the patient, especially if adequate treatment is started late.
It is not possible to restore dead tissue, so the goal of treatment is to stop the process and prevent the development of complications.
How long do people live with gangrene?
Dry gangrene does not affect life expectancy and rarely causes the death of the patient. However, the patient may die from diseases that cause the development of gangrene, for example, from obliterating atherosclerosis, heart attack, stroke.
With wet gangrene, a person can survive for three days or even less without treatment. Therefore, every hour counts.
Prevention of gangrene
1. Proper nutrition, an active and healthy lifestyle - prevention of atherosclerosis and other vascular diseases.
2. Timely treatment of diseases that impair blood circulation, complete rehabilitation after strokes and heart attacks.
3. Prevention and adequate treatment of diabetes mellitus, timely initiation of insulin therapy.
4. Mandatory treatment of various wounds.
5. Avoiding burns and frostbite of the extremities.
Answers to frequently asked questions
Gangrene in diabetes mellitus. What are the features of sugar gangrene?
Diabetes mellitus is one of the main causes of gangrene. Most often, wet gangrene develops, since “sweet blood” is a good breeding ground for many bacteria. For the same reason, treatment sugar gangrene is always difficult and in most cases leads to amputation of the limb.
In diabetes, the most typical gangrene of the foot is diabetic foot, the most severe complication of diabetes mellitus.
Why does diabetic foot develop in diabetes mellitus?
1. Angiopathy– in diabetes, excess sugar over time damages and destroys the wall of small arteries and arterioles, which leads to poor circulation and oxygen deficiency body tissues. In addition to the foot, the vessels of the retina and kidneys are often affected.
2. Reduced skin sensitivity – sugar also negatively affects nervous system. Diabetics often do not feel cold, heat, or pain; patients may grab a hot pan and not understand it. Therefore, when a circulatory disorder begins, they do not have a symptom of pain, which leads to a later visit to the doctor.
3. Diabetes mellitus disrupts all types of metabolism , including fat, that is, diabetics often suffer from atherosclerosis even at a young age.
4. Diabetes has reduced immunity , therefore various bacterial infections, microbes thrive in a sweet environment.
5. The triggers for the development of diabetic foot are:
- wearing tight shoes;
- frostbite – diabetics often do not feel the cold;

Black spots on legs varicose veins veins is evidence that the disease is advanced. This is one of the few symptoms indicating that treatment should be started as soon as possible.

What do black spots mean?

If your legs turn black and the skin changes due to varicose veins, you need to be wary. This usually indicates chronic venous insufficiency. The location of the spots can vary from the feet to the ankles.

Other symptoms of varicose veins include:

leg cramps, worse at night;
feeling of pain in the legs;
swelling after prolonged walking;
increased leg fatigue.

Who is at risk

It is believed that women suffer from varicose veins more often than men. Many people begin to feel the first symptoms of the disease after the age of thirty. Many factors can contribute to the development of pathology, such as pregnancy or childbirth. At this time, varicose veins often appear, but if they already existed, they only begin to get worse.

Due to modern lifestyle, many people are vulnerable to varicose veins. Starting from a young age, the lifestyle is passive, the work is sedentary, there is almost no movement. But walking all the time is also harmful.

Causes of black spots with varicose veins

From the heart, blood flows to all organs through the arteries. IN arterial blood there is oxygen, in its absence the organs simply would not be able to continue their work. IN in good condition The color of blood is bright red.

Blood enters the veins without oxygen. The color of venous blood is dark red. The veins must return blood to the heart and lungs, where it can again be saturated with oxygen. However, lifting blood up is much more difficult, because gravity applies to it. Valves should prevent its return. The muscles in our legs are like pumps; they help push the blood upward.
If there is some kind of malfunction, the load on the valves may increase, they become weak and cannot prevent the return of blood.

After prolonged stagnation, the blood coagulates, forming blood clots. As soon as they block the lumen of the veins, the tissues will not be able to receive oxygen. As a result, they die off and some areas turn black. In a particularly advanced case, you can see that the leg is rotting from varicose veins. Unfortunately, similar complication often ends with the limb having to be amputated.

What to do with black spots
To treat spots, you need to contact a phlebologist. After full examination treatment will be prescribed. Useful application local funds for varicose veins, for example, Varilon Ultra. The cream-gel thins the blood, strengthens blood vessels, and increases the tone of the veins.

In addition, measures need to be taken to improve blood flow in the veins. Useful tips:

wearing compression garments;
taking five-minute walks every half hour;
refusal of flat shoes and high-heeled shoes;
It is not recommended to take oral contraceptives;
regular walks in the morning, twenty minutes is enough;
It is useful to place a cushion under your feet while sleeping;
healthy nutrition, saturation with foods containing fiber;
It is not recommended to wear clothes that compress the body;
It is dangerous to stand or sit for a long time.

With the help of such simple measures, it will be possible to improve blood flow and the condition of the veins will return to normal. In the fight against black spots on legs, each step listed above is mandatory.