SCRIPT NUMBER 98
GANGRENE
(ONE SPEAKER)
PROGRAM NAME: HEALTH NUGGETS
PROGRAM TITLE: 98
PROGRAM NUMBER: GANGRENE
SUBJECT: SYMPTOMS, CAUSES, COMPLICATIONS, TREATMENT,
PREVENTION OF GANGRENE
KEY WORDS: OOZE, NUTRITION, SKIN GRAFT, NICOTINE, FROSTBITE,
SURGICAL REMOVAL, EXPOSED SKIN
DATE OF SCRIPT: FEBRUARY 8, 2013
AUTHOR: RICHARD YUKL, MD, FACS
John lives in a country where the economy is poor, jobs are scarce, and
everyone worries about being able to have enough food to feed their family. A
new road was being built through his area, so John applied for a job as a
construction worker. The construction jobs paid very well. To his delight, he was
hired to operate the paving machine, a heavy machine that receives and spreads
concrete from cement trucks, making a single lane of highway surface. One day
a portion of the delivery boom on his machine became stuck, and, as he tried to
loosen it, a piece of steel fell onto his left hand, causing a small cut on the hand
and a large amount of swelling and pain. He didn’t go to see a doctor. He is
diabetic, so he has to see a doctor often, and he doesn’t like doing it. After
several days, John noticed that, although his hand had been red and bruised at
first, it was slowly changing to a dark brownish color. It was becoming cold to the
touch, and beginning to feel numb. Later, the skin of his injured hand became
black and started draining a bad-smelling ooze. Alarmed, he finally went to see
his doctor only to find, to his sorrow, that gangrene had developed in his injured
hand. His doctor told him that people with diabetes have an increased risk of
developing gangrene after trauma.
Today, I want to talk about gangrene. The word refers to the death of some of
your body’s tissues because of a lack of blood or nourishment flowing to those
tissues, or because of an infection. Gangrene most commonly occurs in the legs
and arms, but it can also develop in muscles or in internal organs. Your blood
provides oxygen and nourishment to the cells of your body, and without that
constant support, the cells die from starvation and begin to decay.
Several factors increase your risk of developing gangrene. One factor is age.
Gangrene occurs far more often in older people. Another factor is diabetes. If you
have diabetes, your body doesn’t produce enough insulin for its needs. As you
eat food, the sugar from that food enters your bloodstream, but without insulin, it
is unable to enter your cells to nourish them.
John had a severe injury to his hand, and trauma is yet another factor for
developing gangrene, especially if you have an underlying medical condition
such as diabetes that may already be hardening and narrowing your arteries,
lowering your blood flow.
Life is full of accidents that cause trauma to some part of your body nearly every
day. Just when should you become concerned enough about a bump or a bruise
to see a doctor? Get help if the injured area becomes pale in color, or if it begins
to turn blue or black. Also, be concerned if a wound doesn’t heal in 1-2 weeks, or
if pain in the wound begins to increase. It is essential to see a doctor if the injured
area begins to develop a foul-smelling odor, or if pus begins to drain from the
area. Your doctor has access to the tests needed to diagnose gangrene, and he
can start you on the proper antibiotics if an infection has begun.
Make no mistake, gangrene is a life-threatening condition. Tissues that have
already developed gangrene cannot be saved, but steps can be taken to prevent
the gangrene from spreading. You must take appropriate antibiotics if an
infection has begun. Your doctor may need to remove dead tissues to allow
injured tissues to heal. Your doctor may even need to repair damaged or
diseased blood vessels to increase blood flow to the involved area. A skin graft
is a type of surgery that may be needed to replace skin that gangrene has
destroyed. During a skin graft, healthy skin is removed from a part of your body
that is normally hidden by clothing and carefully spread over an area where the
skin has been lost, being held in place by bandages or by several small stitches.
In severe cases of gangrene, an affected body part such as a toe, finger or
even an arm or leg may need to be surgically removed to save your life.
John’s doctor was able to cut away gangrene from the back of his hand and start
him on appropriate antibiotics for an infection, saving his hand. The hand might
have required surgical removal had John waited any longer to begin treatment.
Here are a few suggestions that may help you reduce your risk of developing
gangrene. If you find any open wounds, wash them with a mild soap and water at
least twice a day, keeping them clean and dry until they heal. If you are
overweight, get back to a normal weight. Extra pounds not only put you at risk of
diabetes, but they also place pressure on your arteries, narrowing them and
lowering blood flow. If you have diabetes, make sure you examine your hands
and feet every day for cuts, sores and signs of infection such as redness,
swelling or drainage. If you smoke tobacco, quit. The nicotine in tobacco does
actual damage to your blood vessels, slowing blood flow.
Finally, be extra careful in cold weather. Cold air can cause frostbite, a condition
where exposed areas of your skin actually freeze. Frostbite is another form of
gangrene. It most commonly damages areas of your body that are distant from
your heart, and which have had extended cold exposure - areas such as your
fingers and toes. If you have been out in the cold and notice any areas of your
skin becoming pale, hard, cold or numb, call your doctor.
Health Nuggets is written by Dr. Richard Yukl, a medical doctor working in the
United States. The medical views expressed in this program are his and may
differ for your particular health needs. If you need medical advice, please consult
a medical professional in your area.