Healing time and prognosis
The most important principle in the therapy of gangrene is that it can only heal if the cause is eliminated. If this is the case, for example, because a migrated blood clot (embolism) was responsible for it and it was removed, the healing time depends on how far advanced the gangrene was. If the gangrene has been completely removed and any bacteria present have been treated with antibiotics, there is nothing to prevent a complete cure for the time being.
It is important to know that dead tissue, which is present in gangrene, cannot be healed. Only the removal of this tissue is possible. However, if there is a chronic (long-term) cause, such as a smoker’s leg or diabetic foot, the prognosis depends strongly on the actual disease.
In such cases, gangrene may not heal properly on the one hand, and on the other hand it may reoccur. For this reason, correct blood glucose control is essential for diabetics, and for smokers, stopping consumption and sufficient exercise are essential for the prognosis. Especially for smokers and diabetics, especially if gangrene reoccurs, amputation is often not an option due to the lack of prospects for improvement.
What is the difference between gangrene and necrosis?
Gangrene and necrosis behave to each other more or less like the apple to fruit. Necrosis describes cell death as a reaction to damaging influences such as toxins, infections or undersupply. A single cell or entire cell groups can be affected.
Necrosis is divided into the so-called coagulation necrosis and the liquefaction necrosis (colliquation necrosis). Coagulation necrosis can occur in protein-rich tissues, which leads to denaturation (destruction of the structure) of the proteins. A gangrene describes a special form of coagulation necrosis, in which necrotic remodeling occurs in particular due to an undersupply of oxygen.
A gangrene is again divided into a dry and a moist gangrene.While a dry Gangrene appears very sunken and dried out and is therefore also called “mummified”, a moist Gangrene is slightly liquefied, shiny, purulent and malodorous. The reason is the immigration and multiplication of bacteria, which liquefy the Gangrene by their metabolic products. Another special form is the so-called gas fire, in which an infection of the Gangrene with Clostridia (Clostridium perfringens) leads to the formation of gaseous bacterial toxin.
