What is a gangrene?
Gangrene comes from the Greek and means “that which eats away”. This name originated from the outward appearance of a gangrene and the partly very fast spreading of it. A gangrene is a tissue necrosis in which the skin dies and then dissolves and changes.
In former times gangrene was also called “gangrene”. They are divided into dry gangrene, wet gangrene (infected gangrene) and gas gangrene (infection with clostridia). The most common cause of gangrene is a reduced blood supply to tissue, for example due to an arterial occlusive disease, diabetes or frostbite.
Localizations
A gangrene on or rather in the tooth is caused by an inflammation of the dental pulp. The pulp is located inside the tooth and contains the nerves and blood vessels that supply the tooth. Bacterial or chemical factors can cause an inflammation of the pulp and swelling of the pulp.
Since the pulp is surrounded by hard material, the pressure cannot escape, which leads to severe pain. The pressure also causes the vessels to close and the pulp tissue to necrotically rebuild. The substances released during the inflammation, such as ammonia, can escape at the root of the tooth and cause extremely unpleasant bad breath.
In rare cases, the inflammation can spread to the jawbone, which can be very dangerous. The treatment of a gangrene is by drilling the tooth to release the pressure and ensure a rinse (disinfection). A gangrene of the appendix is actually a gangrene appendix.
Appendix is a process located on the appendix that tends to become inflamed. In the large intestine there is a naturally occurring bacterial flora. Either by accident or by the displacement of the appendix, for example by poorly digestible food remains or stool, an infection of the appendix by the intestinal bacteria can occur.
This is followed by a strong swelling of the appendix, which in turn can cut off the blood supply. Appendicitis is divided into several stages, depending on how severely the appendix becomes inflamed or how much the blood supply is inhibited. The last stage is also called “appendicitis gangraenosa”.
It leads to a complete suppression of the blood supply and a death of the intestinal cells. The appendix usually turns a black-greenish color and is characterized by severe pain. During surgical removal of the appendix, which is the only sensible therapy in this case, a foul-smelling odor and a co-infection of the surrounding tissues is also usually noticeable.
A gangrene at the gall bladder is very similar to the gangrene of an appendix. An inflammation of the gallbladder also leads to an undersupply of blood with subsequent necrotic changes in the form of gangrene. In contrast to the appendix, the gall bladder is usually characterized by a build-up of bile acid due to gallstones, which leads to irritation and inflammation.
Bacteria migrate into the actually germ-free wall of the gallbladder, which further increases the inflammation. The increased pressure and additional swelling of the gallbladder wall leads to an undersupply of blood to the gallbladder. The most severe form of inflammation of the gallbladder leads to a subsequent death of the cells and necrotic remodeling, which is then also called gangrene.
At this stage, there is a high risk of the gallbladder bursting (perforation), which can lead to inflammation of the peritoneum and become very dangerous. A Fournier’s gangrene or also called Fournier’s gangrene is a special form of necrotizing fasciitis. It is a bacterial infection that spreads along the fascia.
A Fournier’s gangrene occurs in the genital, perineal or anal region and is a rapidly progressing disease. The skin dies off (necrotizes) and discolors the skin. Redness, itching, swelling and severe pain are also symptoms.
In addition, there is usually a high fever, increased heart rate and poor general condition. A Fournier’s gangrene is accompanied by a mortality rate of 20-50% despite therapy. Such a gangrene is treated with a broad acting antibiotic and a surgical “debridement”.This means that the necrotic skin areas are generously removed and, if necessary, covered by skin grafts at intervals.
Risk factors of a Fournier gangrene are
- Diabetes
- Weakened immune system
- Smoking
- Chronic alcohol consumption
- Overweight
- The male sex
The foot is a very common place for gangrene. The reason for this is that it is caused by an undersupply of blood, including oxygen, to tissue. Feet have an increased risk of blood deficiency due to their long distance from the center of the body and their narrow vessels.
Common causes are: All these causes lead via various mechanisms to a constriction or occlusion of the supplying blood vessels (arteries). This can occur suddenly (for example, due to an arterial embolism) or slowly (for example, due to a diabetic foot). The result is an undersupply of oxygen to the foot, which leads to the tissue dying off.
The skin turns greyish-black and dries up, which is medically known as “mummification” (dry gangrene). If there is additional immigration of bacteria, the gangrene liquefies and is called moist. Moist gangrene also tends to smell very strong and is therefore usually noticed early. Gangrene should, as soon as noticed, be treated medically as soon as possible.
- The arterial occlusive disease (“smoker’s leg”)
- An arterial embolism (migrating blood clot)
- A macroangiopathy (“diabetic foot”)
