Causes
The most common cause of gangrene is a reduced blood supply to tissues far from the body (peripheral), such as feet and fingers, caused by systemic factors. These are mainly diabetes, smoking and diseases of the cardiovascular system. Gangrene of the internal organs is usually caused by a spontaneously occurring inflammation of the respective organ.
The undersupply of blood causes a lack of oxygen in the tissue, which is also called “ischemia” in medicine. This leads to hyperacidity and swelling of the cells. The cell proteins perish (denature) and the tissue begins to decompose.
In diabetes, a lack of insulin (hormone of the pancreas) leads to an increased concentration of sugar in the blood. If this is increased over a longer period of time, a so-called saccharification (glycation) of the “bad” cholesterol (LDL) and an increased deposition of this on the vessel wall can occur. Insulin deficiency leads to an increased breakdown of fat in the body, which in turn leads to an increased concentration of fats in the blood.
All these factors lead to increasing damage to the vascular wall, reducing its diameter and worsening blood circulation. This is medically known as “diabetic macroangiopathy” and can lead to a condition called “diabetic foot“. Smoking has a negative effect on the vascular system in several different ways.
Nicotine affects the nervous system and promotes the release of the stress hormones adrenaline and noradrenaline from the adrenal gland. These constrict the blood vessels and thus increase blood pressure. The oxygen radicals contained in cigarette smoke, which enter the blood through the lungs, damage the vascular wall, which in the long term leads to a narrowing of the blood vessels. Furthermore, cigarette smoke has an influence on fat metabolism and changes the blood consistency by making the blood “thicker” and less able to flow through narrow vessels. All these factors lead in the context of arteriosclerosis to a poorer blood supply, which in the long term leads to a so-called “smoker’s leg” and can manifest itself as gangrene.
