GANGRENE |
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DESCRIPTIONGangrene is dead tissue. Gangrene develops when a wound becomes infected or tissue is destroyed by an accident. Any body part can be affected, but the most common sites are the toes, feet, legs, fingers, hands, and arms. The most dangerous sites are abdominal organs.
Appropriate health care includes:
Physician's monitoring of general condition and medications.
Time in a decompression chamber to halt the progress of gangrene.
Surgery to remove dead tissue, sometimes by amputation.
Physical therapy, if amputation is necessary.
Self-care during convalescence.
SIGNS & SYMPTOMS
Black skin with dead underlying muscle and bone.
Crepitation of the skin. This feels like pressing on air bubbles under the skin.
Swelling.
Pain.
Bad-smelling discharge from ulcers in dead tissue.
Moderate fever up to 101F (38.3C).
CAUSES
Gangrene occurs when blood flow to a body part is blocked or severely reduced. The following may interrupt your child's blood flow and cause gangrene:
Infection with clostridia perfringens germs.
Tissue injury caused by accidents, surgery, or deep puncture wounds.
Crushing injury that cuts off the blood supply.
Blood clot in an artery.
Hardening of the arteries.
Prolonged frostbite.
RISK FACTORS
Diabetes mellitus; smoking, which impairs blood circulation; excess alcohol consumption, which interferes with blood-vessel function.
PREVENTING COMPLICATIONS OR RECURRENCE
If your child has diabetes, it is important to adhere closely to the treatment program to control diabetes. Examine the child's feet often for signs of unhealthy tissue. Keep your child's nails trimmed. The child should wear comfortable, well-fitting shoes.
Consult your doctor if there are signs of infection (warmth, swelling, redness, pain, or tenderness) in your child's skin injury.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory blood cultures from the gangrene site.
X-rays of any suspicious area to detect gas in tissues.
POSSIBLE COMPLICATIONSBlood poisoning; shock; DIC (disseminated intravascular coagulation), a blood-clotting disorder; limb amputation to prevent death.
PROBABLE OUTCOME
Usually curable in the early stages with antibiotic treatment and surgery to remove dead tissue. Without treatment, gangrene is fatal.
TREATMENT
HOME CAREAfter surgery or intensive hospital care:
Wear sterile gloves to change your child's dressings.
Place any material that touches ulcerated areas in double plastic bags and burn it.
Whirlpool treatments and massages help increase your child's circulation.
Your child should not smoke!
MEDICATION
Your doctor may prescribe: antibiotics--usually intravenously in the early stages -- to fight infection; pain relievers; anticoagulants to prevent blood clotting.
ACTIVITY
Your child should rest in bed until gangrene stops progressing and healing begins. Then the child can resume activity gradually. Moving the legs frequently while in bed helps prevent blood clots in deep veins. The child may read or watch TV.
DIET & FLUIDS
Serve a high-protein, high-calorie diet while your child's body is repairing damaged tissue.
Give your child vitamin and mineral supplements, including zinc. The child should take 220mg of zinc orally twice a day.
Encourage your child to drink adequate fluids (6 to 8 glasses daily).
OK TO GO TO SCHOOL?Yes, after treatment is complete.
CALL YOUR DOCTOR IF
Your child has symptoms of gangrene.
Your child has persistent pain, despite medication and treatment.
During convalescence, your child's temperature rises to 102F (38.9C) or higher.
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