When you notice one of your toes turning back, in the case of gangrene, your life can flash before your eyes. Terror, fear, and uncertainty can be just a few of the many emotions that someone dealing with gangrene can experience.
One of the first questions you or a family member may ask when you are dealing with gangrene is "Can gangrene toes be saved?" Gangrene is the death of all bone and soft tissue including muscles, tendons, blood vessels, nerves, and skin. Because of this, gangrene toes can not be saved.
Can Gangrene Toes Be Saved?
What is gangrene?
Gangrene is the death of body tissue caused by a lack of blood flow, or infection. Gangrene commonly affects the toes, feet, legs, fingers, and arms. Gangrene is very destructive, can cause an entire leg to be amputated, and even in the most severe cases, can cause sepsis, and death.
Types of Gangrene
Dry Gangrene: This type usually happens when there is a lack of blow flow or poor circulation. Dry gangrene can be seen with chronic diseases like diabetes, kidney disease, and atherosclerosis. The affected tissue body part, like a toe for example, becomes dry, shriveled, and turns black or dark brown. Dry gangrene usually happens without an underlying infection. Treatment for a toe is dry gangrene is usually surgery to remove a part of, or all of the toe depending on how much of the toe is affected.
Wet Gangrene: Unlike dry gangrene, wet gangrene involves infection. The affected body part becomes swollen, blisters pop up, and there is a foul odor. If you have ever smelled wet gangrene, it is a very unique smell. Smell wet gangrene once, and you'll never forget it. Wet gangrene spreads quickly, and is life-threatening if not treated quickly. Treatment for wet gangrene of a toe is hospitalization, IV antibiotics, and amputation.
Gas Gangrene: Gas gangrene is caused by the bacteria, Clostridium perfringens. This bacteria produces toxins and gas within the tissues, leading to rapid tissue death. Treatment for gas gangrene is also hospitalization, IV antibiotics, and surgery. If a toe has gas gangrene, the toe must be amputated in order to stop the gas gangrene from spreading, and to prevent death.
Causes of Gangrene
The main cause of gangrene toe is the loss of blood supply to the affected area, leading to tissue death. The lack of circulation to a toe for example can be caused by the following:
Peripheral Arterial Disease: Peripheral Arterial Disease (PAD) is when the blood vessels, specifically your arteries, which are responsible for bringing oxygen and nutrient-rich blood from your heart to the rest of your body are damaged or blocked, causing poor to no circulation. When this happens in the toes and left unchecked, it can lead to gangrene. PAD is commonly seen in diabetics, those with Chronic Kidney Disease, heart disease, and smokers, but can also happen outside of these diseases.
Infection: Infection caused by bacteria, especially infection by Clostridium, can lead to gangrene. Open wounds or ulcers and surgical incisions can be entry points for bacteria to enter the toe
Trauma: Major injuries, burns, and frostbite can also damage blood vessels, causing poor blood flow in the toes and toe gangrene.
Weak Immune System: People who are immunocompromised, like those with HIV/AIDS, cancer patients, and those with autoimmune diseases, have an increased risk of developing gangrene toes
Chronic Diseases: Chronic conditions like diabetes, chronic kidney disease, or kidney failure can make it harder for the body to heal wounds, and also lower your immunity, increasing your risk of developing gangrene toes.
Symptoms of Gangrene
The symptoms of a gangrene toe can be slightly different depending on how severe your gangrene toe is, and the type of gangrene you have. Symptoms can include the following:
Dry, black skin, similar to beef jerky (dry gangrene)
Severe pain
Foul odor
Blisters with drainage, the skin here will look very soft or mushy (wet or gas gangrene)
Grey, red, black, or purple skin
fever
increased heart rate
rapid breathing
nausea
vomiting
diarrhea
low blood pressure
Diagnosis of Gangrene
Diagnosing a gangrene toe includes the following
Physical Examination: A thorough examination of the toe to see how severe the tissue damage is, look for signs of infection, and overall blood flow.
Imaging Tests: X-rays and MRIs also can help pinpoint how severe the tissue damage is, or help confirm the presence of gas gangrene, due to being able to see air bubbles in the toe. In some cases, hardened or calcified arteries can actually be seen on x-ray as well.
Blood Tests: White blood cell counts, inflammation, and organ dysfunction can all be tested for through blood tests.
Cultures and Biopsies: A sample of soft tissue in your toe or drainage, usually taken during surgery will confirm the presence of infection, and specifically what type of bacteria is causing the gangrene toe. This way, the antibiotics given can be tailored specifically to the patient. Biopsies can also be used to pinpoint the extent of the tissue damage and guide doctors in whether more tissue or a higher amputation needs to be performed.
Treatment of Gangrene
The treatment of a gangrene toe depends on the type of gangrene you have, and how bad the gangrene has spread. Prompt medical intervention is crucial to prevent the spread of infection and save as much healthy tissue as possible. Treatment options include:
Hospitalization
Because the management of a gangrene toe can involve several doctors including podiatrists, internal medicine doctors, and infectious disease, the patient is usually admitted to the hospital for further monitoring and infection management.
2. Surgical Intervention:
Because gangrene of a toe can spread, and be life-threatening, the definitive treatment for gangrene is amputation. Usually with toe gangrene, the surgery is usually fairly straightforward.
Because gangrene has happened once before, amputation is not the end of the road for these patients. The main concern that any doctor has, when performing an amputation due to gangrene is if the patient will be able to heal the surgical wound.
If this does not happen in a timely fashion, the patient can be left with an ulcer, which can then become infected, and lead to an even higher amputation, leading to the loss of a foot or the leg.
3. Antibiotics: IV and oral antibiotics are key in treating infections seen along with gangrene. The antibiotic used depends on what bacteria are found in cultures.
4. Wound Care: Healing the surgical wound of someone with gangrene can be a potentially long process. Because of this wound care is provided to the patient, in usually weekly visits at a doctor's office where dressings are changed, treatments applied, and photos and measurements of the wound are taken to track its progression.
Prevention of Gangrene
Preventing toe gangrene involves addressing the root cause of why gangrene can develop, and being proactive.
1. Manage Chronic Disease: Chronic diseases such as diabetes, peripheral artery disease, and hypertension being kept in check is key. Regular check-ups, medications, and lifestyle changes can help control these conditions and lower the risk of gangrene.
2. Wound Care: Especially if you are diabetic, smoke, have neuropathy, chronic kidney disease, or PAD, any blister, wound, cut, or scrape on your foot can potentially be an amputation down the road. If you ever notice these things on your daily foot checks, make an appointment with your local foot doctor immediately. We can provide the right kind of wound care to lower the chances that gangrene will develop.
3. Avoid Extreme Temperatures: Protecting your feet from extremely hot or cold temperatures, will prevent either frostbite or burns, which can lead to gangrene. Do not go barefoot if you are at high risk for developing gangrene.
5. Healthy Lifestyle Choices: Making healthy lifestyle choices that include a diet high in fresh, natural foods, and healthy fats, regular exercise, and stopping smoking if you do can improve overall circulation and immune function, lowering the risk of a gangrene toe.
Conclusion
Gangrene is a serious and even deadly health problem that calls for speedy medical attention. Understanding the different types of gangrene, and how they may look like or present, can help you and your loved ones make an informed decision, and also act quickly whenever you see a gangrene toe. As always, lifestyle changes, management of chronic disease, and avoiding exposing your feet directly to extremely hot and cold temperatures are critical to prevent developing another gangrene toe in the future.
Schedule Your Appointment at Direct Podiatry Arizona
Are you in need of a podiatrist in Phoenix? My name is Dr. Tarr, and I am the owner of Direct Podiatry Arizona in Tempe. To view my available appointment times, click here.
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